NEWSLETTERNewsletter of the Society for Academic Emergency Medicine July/August 2002 Volume XIV, Number 4

PRESIDENT’S MESSAGE

Some Thoughts RegardingGender Issues in theMentoring of FutureAcademicians

As academicians in emergency medicine(EM), we must consider the steps we should betaking now to ensure that the next generation ofEM academicians are fully prepared to fulfill thescientific, educational, and clinical roles of thefuture. One of the most important predictors of

academic success, at least as judged by traditionalmeasures (e.g., research productivity, publications, and extramural fund-ing), is the availability of a mentor during the young academician’s criticalperiod of development (e.g., fellowship and the first years as faculty). Whilea number of insightful authors have discussed a number of importantaspects of the mentor, and of the mentor-mentee relationship, whichincrease their value to the young academician, in this column I will focus ona topic which is usually not mentioned: the issue of gender and its impacton the mentoring of young academicians. As in my last column, I will beginby considering a myth, a statement that seems eminently true, at least untilexplored more carefully.

Consider the following statement: "The process of mentorship should begender blind; anything else is discriminatory and inappropriate." Althoughmany of us are probably inclined to agree with this statement, possiblybecause it appeals to our sense of fairness and equity, I believe that thisstatement is not true and, moreover, belief in this myth is a barrier to theoptimal training and academic development of women in academic emer-gency medicine.

Before addressing specific gender issues in mentorship, it is useful toreview some recent studies evaluating the challenges facing women in aca-demic medicine. In a recent study,1 Nonnemaker demonstrated thatwomen are still under-represented in senior academic positions, despitenear gender equality (44%) in incoming medical school classes. In addi-tion, she found that women were more likely to enter academic careers thanmen, but less likely to be promoted to the level of Associate Professor. Inan associated editorial,2 Catherine D. De Angelis stated that "…women whohave reached the rank of Associate Professor have had time… to provetheir worth. It just seems to take more proof for women than for men." [Dr.De Angelis is the current editor of the Journal of the American MedicalAssociation.] In contrast to Nonnemaker’s study, which addressed bothbasic science and clinical departments within medical schools, Cydulka etal addressed the status of women in academic EM in a study published inAcademic Emergency Medicine in 2000.3 Cydulka et al found that "Womenin academic EM were less likely to hold major leadership positions, spent agreater percentage of time in clinical and teaching activities, published lessin peer-review journals, and were less likely to achieve senior academic

Roger J. Lewis, MD, PhD

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SAEM NEWSLETTER

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saem@saem.org

www.saem.org

Medical Student InterestGroup Grants

Deadline: September 4, 2002

SAEM recognizes the valuable role of EMMedical Student Interest Groups to the special-ty and has established grants of up to $500each to help support these groups' educationalactivities. Established or developing clubs,located at medical schools with or without EMresidencies are eligible to apply. The deadlinefor this year's grants is September 4, 2002.Applications can be obtained at www.saem.orgor from the SAEM office. Information on thegrants approved for funding earlier this year canbe found in the January/February 2002 issue ofthe SAEM Newsletter. In addition two articles inthe May/June issue of the Newsletter describedrecipients’ use of their grant funds.

Emergency MedicineActivities at the AAMC

Annual MeetingThe Association of Academic Chairs of

Emergency Medicine (AACEM) and SAEM havedeveloped a presentation and panel discussionto be held on Sunday, November 10, 2002 dur-ing the AAMC Annual meeting. The sessions willbe held at the San Francisco Hilton Hotel.

All emergency physicians are invited toattend any of the sessions at no charge.However, pre-registration for lunch is required.You can register for lunch via email atsaem@saem.org. Contact the SAEM office withany questions.

The sessions begin at 8:00 am with a pres-entation entitled “ED Overcrowding: Threat toEM Residency Training”, sponsored by SAEM.Speakers will include Brent Asplin, MD, RobertDerlet, MD, and Mark Henry, MD. At 9:45 am,John Moorhead, MD, will speak on “WorkforceIssues in Emergency Medicine”. Dr. Moorheadis a past-President of ACEP and currently headstheir Workforce Taskforce. At 10:45 am,AACEM will hold its Business meeting and from11:30 am to 1:00 pm, lunch will be provided.Once again, all emergency medicine physiciansare welcome to attend.

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Grant Review Initiative ReportJeff Kline, MDCarolinas Medical CenterSAEM Research Committee

At the 2002 SAEM Annual Meeting,the Research Committee embarked ona specific objective of implementing amechanism to assist in the review ofgrant applications written by SAEMmembers. The ultimate vision of thisproject is to develop a network ofreviewers who can assist in the devel-opment of competetive grant applica-tions, especially for investigators whoare located at hospitals with relativelylimited academic resources to assist ingrant writing. The committee recog-nizes this as a potential long-term proj-ect, so at this stage, the first step inmaking this vision a reality was to imple-ment a system to review grants thathave already been submitted andreviewed by extramural funding agen-cies and not yet approved for funding.The Research Committee solicited andreceived several meritorious grant appli-cations. The review panel chose twothat were previously reviewed by feder-al funding agencies.

The brave souls who offered theirapplications for review were Dr. LeslieZun of Finch University and MountSinai in Chicago and Dr. Larry Melnickerof New York Methodist Hospital. Dr.Zun's application was entitled,"Changing Behavior: Identifying andTreating At-Risk Youth" and Dr.Melnicker's project was, "TheSonography Outcomes AssessmentProgram (SOAP)." Dr. Zun's applicationhad previously been reviewed at theCenters for Disease Control andPrevention (CDC) and Dr. Melnicker'shad been reviewed by the Agency forHealthcare Research and Quality(AHRQ).

To review these applications, theResearch Committee enlisted theexpertise of Dr. Lynn Richardson, ViceChairman of the Department ofEmergency Medicine at Mount Sinai inNew York City, the Honorable Dr. JeffreyRunge, the Administrator for theNational Highway Traffic and SafetyAdministration, and Dr. Judd Hollander,Director of Research at the University ofPennsylvania. All three reviewers haveexperience in reviewing federal grants.The session was held in a small room toencourage a roundtable-type atmos-phere and to foster face-to-face dia-logue and to make the exchange ofideas more personal. Each applicant

first summarized his side of the story,and the reviewers then provided feed-back. In the review of Dr. Zun's applica-tion, Dr. Richardson emphasized thatthe "devil is in the details" and suggest-ed that the application had a relativelybroad scope of aims and would be bet-ter served producing a more specificfocus. Dr. Richardson suggested thatthe specific aims section be pared toone aim that is split out into severalsteps. Dr. Runge echoed Dr.Richardson's concerns, specifically stat-ing that federal funding agencies arehesitant to approve an application whichproposes to derive a scoring system. Dr.Richardson stated the importance of"hitching your wagon to an experiencedinvestigator" to make the applicationstronger, and the requirement for thebackground of the grant to lead thereader exactly to a place where it isclear why the work needs to be done.Dr. Runge emphasized the imperative toknow the reviewers. What they want tosee is a scoring system that has alreadybeen established and is being imple-mented. He also indicated that althoughthe applicant does not know the exactidentity of his or her reviewer, he canfind out the basic background and publi-cation history of the reviewers for anyfederally funded grant.

In review of the SOAP study, Dr.Hollander again hammered home thepoint of having a focus grant applicationand narrowing the breath of the specificaims into what could truly be consideredthe specific goal. In particular, Dr.Hollander suggested that the study befocused on one specific aim which couldalone be an entire project. With whatmust be recognized as wry humor, Dr.Hollander offered multiple examples ofthe importance of writing the methodssection in real terms that are explicit anddetailed: "Who is going to fill out thisform? Who will carry it to the office andwhere will it be stored? What will you doif you drop the form on the way to theoffice?" He indicated the need to enlistestablished statisticians who have spe-cific publication history in solving theproblems that will likely arise with analy-sis of the data from a multicenter EDstudy. He also indicated the need for theapplicant to have a publication history inrigorous peer review journals. Others inthe room offered pithy and helpful com-

ments during the session.In general, the comments from the

50-odd persons participated in orobserved the session were very posi-tive. Several young investigatorsremarked that the session was valuableto what was happening in their careersat present. In follow-up, the two appli-cants also offered positive comments.Dr. Zun called it a "wonderful learningexperience that was unparalleled ininterpreting the unspoken words fromCDC." Dr. Zun is working on a revisionof his application which will contain sub-stantial changes based on the com-ments of the reviewers in the session.Dr. Melniker thanked the ResearchCommittee and the reviewers "for clari-fying so many issues and confirming theneed for new learning." The sessionallowed him to recognize that, "I havepassionate collaborators on my ultra-sound research, but our passion alonecan not offset the complexity of SOAP."Dr. Melnicker used the experience aspart of his decision to matriculate in anMPH program at Cornell's MastersProgram in Clinical Epidemiology andHealth Services Research.

Based on the experience in St.Louis, and the subsequent feedback,the Research Committee plans to con-tinue this project. It should be empha-sized that this "Roundtable Review"comprises only a first step for the devel-opment of a truly prospective grantreviewing mechanism. At this time, theResearch Committee is again solicitingapplications that have not yet beenfunded in an effort to repeat last year'seffort. During the course of this year,the Research Committee will seek todevise a plan to make the review sys-tem a resource that can be used bymembers of SAEM. It is our eventualhope that once an application isapproved through our review processthat we will be able to keep a trackrecord of all of those applications andwith luck, the funding rate will be veryhigh. Perhaps with this "stamp ofapproval" could take the form of a con-sensus letter that could be included as aappendix item for federal grant applica-tions. It is our hope that in the futuresuch a letter of endorsement will actual-ly help improve the score of federallyfunded grant applications.

SAEM Research Training Grant UpdateJason S. Haukoos, MDHarbor-UCLA Medical Center

I am beginning the second-year of atwo-year research fellowship at Harbor-UCLA Medical Center in Torrance,California. I became interested in emer-gency medicine, clinical research, and acareer in academic medicine as a med-ical student at the UCLA School ofMedicine. During my last year of resi-dency at Harbor-UCLA Medical Center, Iapproached Roger J. Lewis, MD, PhD,about initiating a research fellowship.Dr. Lewis discussed with me what hebelieved was required to achieve appro-priate training in emergency medicineresearch that would translate into a pro-ductive academic career.

The first step was to obtain extramu-ral funding for two years of training. Iapplied for and received a ResidentResearch Year Grant (now known as aResearch Training Grant) from SAEM,as well as an Individual NationalResearch Service Award (NRSA) fromthe Agency for Healthcare Researchand Quality (AHRQ).

The foundation of my fellowshipincludes: (1) performing a study aimedat improving identification of undiag-nosed HIV-infected patients who pres-ent to the emergency department (ED)by improving compliance with referralsfrom the ED for outpatient HIV counsel-ing and testing (HIV-CT); (2) obtaining aMaster of Science degree inEpidemiology from the UCLA School ofPublic Health; and (3) functioning as aclinical instructor in the Department ofEmergency Medicine at Harbor-UCLAMedical Center.

The study is based on previous pilotdata in which only approximately 10% ofreferred patients presented for outpa-tient HIV-CT after being referred fromthe ED. Of these, approximately 10%tested positive for HIV. At our institution,patients identified by emergency physi-cians as being at risk for HIV infection,based on current guidelines, are giveninstructions and directions to theImmunology Clinic at Harbor-UCLAMedical Center for confidential outpa-tient HIV-CT. The main goals of the cur-rent study are to determine whether afinancial incentive will: (1) improve theproportion of patients who comply withHIV-CT; (2) improve the proportion ofHIV-infected patients identified; and (3)improve the proportion of HIV-infectedpatients who enter into treatment fortheir disease. In addition, the HealthBelief Model (a previously validatedsocial psychological model designed toidentify barriers to compliance withmedical treatment) is being applied to allreferred patients in the form of a ques-tionnaire with the hope of identifyingperceived or real barriers to HIV-CT.Patient enrollment is currently ongoingand will be complete by the end of myfellowship in June, 2003.

In the fall of my first fellowship year, Ientered the UCLA School of PublicHealth to obtain a Master of Sciencedegree in Epidemiology. The emphasisof this degree program is advancedresearch methodology and statisticalanalysis, and I will complete the degreethis winter during the second year of my

fellowship. This has been an essentialpart of my fellowship, and I could nothave achieved the same level of trainingwithout obtaining this degree. The levelof sophistication and the degree withwhich I have learned about study designand analysis is truly unparalleled.

Additionally, during my first fellow-ship year, I presented abstracts at the9th UCLA AIDS Institute ScientificSymposium in Culver City, Californiaand the SAEM Annual Meeting in St.Louis, Missouri, and had an abstractaccepted for presentation at theResearch Forum at ACEP in Seattle,Washington, in October. Furthermore, Isubmitted two manuscripts for publica-tion and have several others in prepara-tion.

My experiences over the past yearhave reinforced my belief that severalcomponents are important for substan-tial training in research. These include:(1) a strong relationship with an estab-lished mentor; (2) a two-year time peri-od in which to complete the fellowship;(3) performing a well-conceptualizedresearch project in which the fellow actsas the principal investigator; (4) obtain-ing an advanced degree in researchmethodology and biostatistics; and (5)continuing with clinical duties. My fel-lowship, to this point, has been uniform-ly excellent, and I have acquired a foun-dation of skills that I hope will provide fora long and fulfilling career in academicemergency medicine.

Board of Directors UpdateThe SAEM Board of Directors meets

each month, usually by conference call.This article will highlight the Board’sactivities during the June and July con-ference calls.

Because of the recent changes inthe membership application process,including the development of an attesta-tion that the applicant is active in aca-demic emergency medicine, rather thanproviding a letter verifying his/her facul-ty appointment, the Board agreed to dis-continue the $25 membership initiationfee for all categories of SAEM member-ship. The Board noted that the initiationfee had been developed many yearsago when considerable effort was need-

ed to process new member applica-tions. With the advent of online applica-tions and the recent changes in mem-bership requirements that wereapproved as amendments to theConstitution and Bylaws by the mem-bership, the Board agreed that the initi-ation fees should be discontinued. Thenew membership application is pub-lished on page 18 of this issue of theSAEM Newsletter.

The Board approved a proposedResident Mentoring Program to be pro-vided to the resident members of SAEMwho have been appointed to an SAEMcommittee or task force. The goal is toprovide an orientation to SAEM, as well

as to provide mentoring to residents tomaximize their experience withinSAEM. The Board also approved toprovide all resident members with theopportunity to join one SAEM interestgroup without payment of interest groupdues.

The Board approved a letter to besent to Child magazine expressing con-cern over a recent article on pediatricemergency medicine. The letter wassigned by the American Academic ofPediatrics, ACEP, and SAEM and hasbeen accepted for publication.

The Board approved the UltrasoundEducation Slide Set proposed by Sarah

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Board of Directors Update (Continued)Stahmer, MD. The slide set will be post-ed on the SAEM web site in conjunctionwith the new Ultrasound Image Bank.

The Board approved the invitation ofthe National Association of EMSPhysicians to jointly revise the EMSFellowship Curriculum developedapproximately ten years ago. TheSAEM EMS Interest Group will workwith NAEMSP to develop the revisionthat will be forwarded to the Board forapproval.

The Board approved a proposal fromLeslie Wolf, MD, to use the funds donat-ed on behalf of Michael Spadafora, MD,to develop a scholarship program. Thescholarship program will fund two indi-viduals to attend the North AmericanCongress of Clinical Toxicology eachyear. The program is being fundedthrough the American College ofMedical Toxicology and through thefunds donated to SAEM in Dr.Spadafora’s memory. Further detailswill be published in upcoming issues ofthe Newsletter.

The Board approved a request fromthe Council of Emergency MedicineResidency Directors (CORD) to provideup to $500 to fund a CPC Reception to

be held during the ACEP ScientificAssembly. All CPC sponsors (ACEP,CORD, EMRA, and SAEM) will beasked to provide funding for the recep-tion which will be held immediately fol-lowing the CPC Finals Competition onOctober 7.

The Board reviewed the invitationfrom the American Academy ofEmergency Medicine to participate inthe AAEM International Meeting to beheld in Barcelona in September 2003.Dr. Judd Hollander was appointed asthe Board Liaison to work with AAEMand develop a specific proposal for theBoard’s consideration.

The Board approved a letterexpressing support for the NationalHospital Ambulatory Medical CareSurvey. The letter also expressed con-cern with the triage measures currentlyincluded in the Survey.

The Board approved a proposed let-ter developed by the National AffairsCommittee that outlined SAEM’s com-ments on the proposed changes in reg-ulations under the Emergency MedicalTreatment and Labor Act (EMTALA).The text of the letter is published in thisissue of the Newsletter.

The Board approved the develop-ment of a task force to develop a mech-anism for improving the quantity andquality of educational research conduct-ed and presented at the AnnualMeeting. The task force will be chairedby Katherine Heilpern, MD.

The Board agreed to forward the ref-erences submitted by AdrienneBirnbaum, MD, and Jill Baren, MD, toABEM for consideration for the ABEMLifelong Learning Program.

The Board approved the proposedPatient Safety Curriculum submitted byKaren Cosby, MD, on behalf of thePatient Safety Task Force. The Boardalso approved a manuscript submittedby Craig Newgard, MD, on behalf of theResearch Committee. Both manu-scripts will be submitted to AEM for con-sideration.

The next Board meeting will be heldduring the ACEP Scientific Assembly inSeattle on Monday, October 7 at 1:00-5:30 pm. The meeting room has not yetbeen confirmed but will be posted on theSAEM web site upon receipt. All SAEMmembers are invited to attend this, andall Board meetings.

The SAEM Consult Service has along history beginning with the Societyof the Teachers of Emergency Medicine(founded by Gus Russi in the late1970s). Its greatest activity was underthe guidance of Steve Dronen, MD,who chaired the Consulting Service formany years and provided over 70 con-sultations during the 1990s. The SAEMConsult Service is well prepared to offerits considerable capabilities to interest-ed parties in our specialty.

Although a variety of services areavailable, the primary foci have beenthe following:1. Establishment of an EM residency –

this consult is in advance of applica-tion to the ACGME and RRC-EM forconsideration of a new EM residen-cy. The consultation will assess thesuitability and potential of the site forresidency training and assist in thedevelopment of the program infor-mation forms required by theACGME. This service has beensuccessfully offered to more than 40programs in the last two decades.

2. “Mock” survey prior to RRC-EM sitesurvey – this service serves as apreparatory guide to residenciespreparing for their official site surveyby the RRC-EM. This is a usefulprocess for making sure the issuesof potential concern by the RRC-EMare addressed, and convincing insti-tutional administration of the bene-fits of EM and its continued support.There have been more than 40 ofthese consults in the last 20 years.

3. Research Consultation – this rela-tively new aspect of the servicehelps programs develop a researchprogram suitable to their environ-ment. Several sites have participat-ed in this type of consultation withappropriate guidance and net gainsin their research activity.

4. Faculty Development – EM remainsone of the few specialties thatrequires faculty development as partof its program requirements.Programs who are initiating or hav-ing difficulty in this area may requesta faculty development consultation

to assist in planning effective pro-grams for their faculty.

Consultations are done by experi-enced individuals who are ProgramDirectors, Academic Chairs, and/orRRC-EM Site Surveyors. Usually 1-2individuals participate in the consulta-tion depending upon the needs of theinstitution. The individuals are selectedwith input from the institution and theconsult service. Fees are $1,250 perindividual per day plus expenses. Anadditional $500 is paid to SAEM to sup-port the administrative aspects.

The 1980s and 90s were a time oftremendous growth for EM residencies.The Consult service played a significantrole in sustaining the quality of theseresidencies and assisting numerousProgram Directors in developing andcreating solutions to their problems.The SAEM Consult Service looks for-ward to assisting in residency or aca-demic development needs. Please con-tact me directly or through SAEM for fur-ther information and assistance.

Opportunities Available Through the SAEM Consult ServiceGlenn Hamilton, MDWright State UniversityChair, Consulting Service Task Force

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Anti-terrorism FundingJames Olson, PhDWright State UniversitySAEM Research Committee

Within one month of the September11, 2002 attacks, President Bush rec-ommended that Congress allocate $1.5billion in new funding to enhance thecountry’s ability to respond to or repel abio-terrorist attack. A furor for increasedfederal spending was spurned, in part,by the receipt of anthrax-contaminatedletters sent through the US mail to con-gress persons and TV personalities.Nine months later, the Presidentendorsed a $28.9 billion anti-terrorismfunding package of which bio-terrorismis a significant portion. With all the bil-lions of dollars targeted toward thesespecific biological and medical issues,scientists and physicians are aligningtheir research programs and other activ-ities toward these funding opportunitiesin order to contribute to this importantnational priority.

The majority of anti-terrorism fundingis destined for training and for rebuildingand strengthening current infrastructure.The bio-terrorism component of thisfunding is designed to increase the sup-ply of current vaccine stockpiles and therange of organisms they target,strengthen surveillance programs thatcoordinate state and local public healthsystems, improve hospital disaster pre-paredness, and provide enhanced train-ing for emergency workers. From thisshort list, the opportunities for emer-gency physician/scientists can easily befound. Since some of this federalmoney is being sent directly to thestates as block grants for governors tofund their own programs as they see fit,local and state funding agencies mayalso be sought for specific projects. Alist of bioterrorism funding by state can

be viewed at www.hhs.gov/ophp/fund-ing.

The prime institute at NIH that isestablishing new programs and refiningcurrent research programs relevant tobio-terrorism is the National Institute ofAllergy and Infectious Diseases (NIAID).Some of this money is destined toenhance the reserves of antibiotics andvaccines for specific likely bio-terrorismagents. Other research money will go tobasic and applied research targeted atmicrobes and the specific and nonspe-cific host defense mechanisms againstthese microbes. These research dollarswill be directed toward three major com-ponents of the NIAID Strategic Plan forBiodefense Research. First, is basicresearch to better our understanding ofthose microbes recognized as agents ofbioterrorism (see Lane et al. NatureMedicine, 7:1271-1273, 2001). Secondis research into the role of host defensein combating agents of bioterrorism.Finally, funding will go toward construc-tion and certification of biocontainmentfacilities.

Additional sources for funding rele-vant to bioterrorism can be found bysearching any one of several fundingopportunity databases such as thoseoffered by InfoEd International (SPINsearch) or the Community of Science.Using the keyword “bioterrorism” on theSPIN search engine, I obtained a list of10 programs in early August, 2002including: Biodefense ResearchTraining and Career DevelopmentOpportunities (http://www.niaid.nih.gov/dmid /b io ter ror ism/b iodt ra in -ing020529.htm) and HyperacceleratedAward/Mechanisms in Immuno-modula-

tion Trials (http://grants.nih.gov/grants/guide/rfa-files/RFA-AI-02-003.html)from the NIAID and Scientific ResearchFor Center For Drugs and EvaluationResearch (http://www.eps.gov/spg/HHS/FDA/DCASC/223-02-3003/list-ing.html) from the Food and DrugAdministration. A similar search on theCommunity of Science database yielded16 possible funding sources whichincluded: Interagency AdvancedDistributed Learning EmergencyManagement Training for AgriculturalBioterrorism Response from theTechnical Support Working Group of theCombating Terrorism TechnologySupport Office (https://www.bids.tswg.gov/tswg/bids.nsf/Main?OpenFrameset&57YJ2V), Informatics for DisasterManagement from the National Libraryof Medicine (http://grants1.nih.gov/grants/guide/pa-files/PAR-02-137.html),and Diagnosis of Biological ThreatsThrough Bioinformatics (A02-169) fromthe Department of Defense (http://www.acq.osd.mil/sadbu/sbir/solicitations/sbir022/army022.htm).

Thus, from basic science on micro-organisms to epidemiological assess-ments of public health data and applieddisaster management, there is a sourceof research funding within the broadscope of the various anti-terrorism andbiodefense bills which have emergedfrom Congress in the past year. Themajority of funds will come through fed-eral agencies such as the Departmentof Defense, the Food and DrugAdministration and the NIH. However,local and state agencies also may pro-vide funding for projects and should beconsulted.

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 popu-larity, more advisors are needed. Newstudents are applying daily, and over100 remain unmatched! Please consid-er mentoring a future colleague bybecoming a virtual advisor today. It is abrief time commitment – most communi-

cation takes place via e-mail at yourconvenience. Informative resourcesand articles that address topics of inter-est to your virtual advisees are availableon the SAEM medical student website.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.

In September of 2001, theAccreditation Council for GraduateMedical Education (ACGME) appointedthe Work Group on Resident DutyHours. This group was appointed toaddress concerns that restricted sleepcould have a detrimental effect onpatient safety, education, and residentsafety and well-being. On June 11,2002, the Work Group issued its report,which consisted of common require-ments of all accredited programs, insti-tutional requirements for oversight andsupport, and strengthening the systemsof compliance.

The standards are rigorous and well-defined. There will need to be changesmade by many programs in order tocome into compliance. The standardsalso address moonlighting activities,forcing the institution, individual residen-cy program, and the resident to worktogether to stay in compliance. Thesestandards therefore have implicationsthat will affect all three.

The Work Group established com-mon accreditation standards in regardsto duty hours. The requirements are:1. Residents must not be scheduled

for more than 80 duty hours perweek, averaged over a four-weekperiod, with the provision that indi-vidual programs may apply to theirsponsoring institution’s GraduateMedical Education Committee(GMEC) for an increase in this limitof up to 10 percent, if they can pro-vide a sound educational rationale;

2. One day in seven free of patientcare responsibilities, averagedover a four-week period;

3. In-house call no more frequentlythan every third night, averagedover a four-week period;

4. A 24-hour limit on in-house callduty, with an added period of up to6 hours for inpatient and outpatientcontinuity and transfer of care, edu-cational debriefing and didacticactivities; no new patients may beaccepted after 24 hours;

5. A 10-hour minimum rest periodshould be provided between dutyperiods; and

6. When residents take call fromhome and are called into the hospi-tal, the time spent in the hospital

must be counted toward the week-ly duty hour limit.

There are additional institutionaloversight requirements, including,“Institutional policies on patient careactivities external to the educationalprogram (moonlighting), prospectiveapproval of these activities, and moni-toring their effect on performance in theeducational program.” Of significance isthe next institutional oversight state-ment which states, “Counting time spentin patient care activities external to theeducational program that occur in theprimary program and institution towardthe weekly duty hour requirement.”Institution

The institution is required to provideoversight of each individual residency’spolicies, require justification for increas-es above the 80 hour limit, provide anannual report on duty hour compliance,develop institutional policies related topatient care activities external to theeducational program (moonlighting),and provide patient care support servic-es such as phlebotomy, IV, and trans-port services. Every residency programgoes through an internal review by theGMEC that reviews ACGME compli-ance prior to an accreditation site visit.In order to maintain compliance with theduty hours requirement, each institutionwill need to review an annual reportfrom each residency on duty hour com-pliance.Residency

The duty hours requirements willforce numerous changes by every resi-dency. Some will need to revise rota-tions to be in compliance. All programswill need to develop policies and com-pliance systems to ensure that the dutyhours requirements are fulfilled. Foremergency medicine rotations, all timespent in patient care activities,research, EMS, and conference timewill count towards the 80 duty hours perweek. As an example, if a programmandates twenty 10-hour ED shifts dur-ing the month, the actual time may inreality be 220 hours for the month dueto “staying over” to complete patientcare. Conference time of 20 hours,EMS time of 3 hours, and any otherrequired duty hours will bring the totaltime up to 243 hours for a four week

period. Any external patient care activi-ties (moonlighting) must be added tothese hours, and must be within anaverage of 80 hours a week over thefour week period. Additionally, eachprogram must ensure that one day inseven is free of patient care responsibil-ities.

On off-service rotations, the emer-gency medicine residency program willneed to work closely with the off-servicedepartments to ensure compliance.Formal written agreements between thetwo departments will need to incorpo-rate the duty hours requirements. Foroff-service rotations in which there is in-house call, it will be easy to approachand exceed 80 hours per week. As anexample, if an intern is on a floor medi-cine service requiring in-house callevery third day, the total hours willapproach 20 days at nine hours each(180), and nine on-call days for an addi-tional 135 hours, yielding 325 hours.Additionally, after a total of 24 hours ofcontinuous duty, there must not be anynew patients added to that resident’sresponsibilities (for example, newadmissions). After an on-call period,there is a limit of up to 6 additional hoursfor inpatient/outpatient care, education-al activities, etc. This will effectivelyforce the resident who was on-call thenight before to leave by 2:00 pm thenext day after call.

Many programs either allow moon-lighting, or weakly monitor and enforcea moonlighting policy. The new require-ments mandate that moonlighting hoursbe counted towards the duty hoursrequirements, and that its effect on per-formance in the educational program bemonitored. This will force each programto develop new moonlighting policiesthat will be in compliance with the dutyhour standards. Additionally, prospec-tive approval of moonlighting is nowmandated, meaning that all plannedmoonlighting activities must be submit-ted to the program and that they mustbe counted toward the total duty hours.It is clear that for those programs thatminimally followed their residents’moonlighting activities in the past, theymust now monitor moonlighting hours toensure the duty hours standards are not

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Implications of the ACGME Work Group on Resident Duty HoursRecommendations

Michael Beeson, MDSumma Health SystemChair, SAEM Graduate Medical Education Committee

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Resident Duty Hours(Continued)

exceeded.Resident

The resident must take a proactive rolein compliance with the duty hours require-ments. Ideally, residents will work with theirindividual programs to monitor complianceon ED rotations as well as off-service rota-tions. The resident must remember that allmoonlighting activities must be countedtowards the weekly duty hour limit. It is nowrequired that all residencies monitor moon-lighting activities. This may seem intrusive,but will force significant change by the resi-dent and the program in terms of how moon-lighting is viewed.Conclusion

The new duty hours requirements willforce institutions, residency programs, andresidents to work together towards compli-ance with the duty hours requirements. Thedegree of change required to come intocompliance will vary with each program andinstitution. However, even if an institution orresidency is currently in compliance, at theleast monitoring systems will need to beestablished that will ensure continued com-pliance.

SAEM Meetings in SeattleThe following SAEM meetings will be held during the ACEP Scientific Assemblyin Seattle. Meeting room assignments will be posted when confirmed by theACEP office. All members are invited to attend.

Saturday, October 51:00-3:00 pm, Program Committee Executive Committee4:00-6:00 pm, Program Committee6:30-7:30 pm, Annual Meeting/Program Committee Task Force

Sunday, October 68:00-12:00 noon, Didactic Subcommittee11:00-12:00 noon, Undergraduate Committee1:00-3:00 pm, Scientific Subcommittee of the Program Committee3:00-4:30 pm, Medical Student/Resident Subcommittee of the ProgramCommittee3:00-4:30 pm, Public Health Task Force4:30-5:00 pm, Program Committee Task Force meetings5:00-6:00 pm, Program Committee

Monday, October 710:00-11:00 am, Faculty Development Committee1:00-5:30 pm, Board of Directors1:30-2:30 pm, Ethics Committee2:30-3:30 pm, Evidence Based Medicine Interest Group3:30-5:00 pm, Graduate Medical Education Committee5:00-6:30 pm, Grants Committee

Tuesday, October 87:30-9:00 am, Financial Development Committee9:00-10:00 am, Research Committee3:00-4:00 pm, AEM Associate Editors400-6:00 pm, AEM Editorial Board

Call for PhotographsDeadline: February 17, 2003

Original photographs are invited for presentation at the SAEM 2003 Annual Meeting in Boston. Photographs ofpatients, pathology specimens, gram stains, EKG’s, and radiographic studies or other visual data may be submitted.

Submissions should depict findings that are pathognomonic for a particular diagnosis relevant to the practice of emergency medi-cine or findings of unusual interest that have educational value. Accepted submissions will be mounted by SAEM and presentedin the “Clinical Pearls” session and/or the “Visual Diagnosis” medical student/resident contest.

No more than three different photos should be submitted for any one case. Submit one glossy photo (5 x 7, 8 x 10, 11 x 14, or16 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). Radiographsshould be submitted as glossy photos, not as x-rays. For EKGs send an original and a digital image. The back of each photoshould contain the contributor’s name, address, hospital or program, and an arrow indicating the top. Submissions should beshipped 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) chief com-plaint, 2) history of present illness, 3) pertinent physical exam (other than what is depicted in the photo), 4) pertinent laboratorydata, 5) one or two questions asking the viewer to identify the diagnosis or pertinent finding, 6) answer(s) and brief discussion ofthe case, including an explanation of the findings in the photo, and 7) one to three bulleted take home points or “pearls.”

The case history must be submitted on the template that is 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 right toedit the submitted case history.

Submissions will be selected based on their educational merit, relevance to emergency medicine, quality of the photograph, thecase history and appropriateness for public display. Contributors will be acknowledged and photos will be returned after the AnnualMeeting. Academic Emergency Medicine (AEM), the official SAEM journal, may invite a limited number of displayed photos to besubmitted to AEM for consideration of publication. SAEM will retain the rights to use submitted photographs in future educationalprojects, 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 isolateddiagnostic studies such as EKGs, radiographs, gram stains, etc. The attestation statement is included in the submission template.

SAEM

SAEM Responds to Proposed Changes in EMTALAOn June 26 SAEM sent the following letter to Thomas A. Scully, the Administrator of the Centers for Medicare and MedicaidServices (CMS). The letter was developed by the National Affairs Committee, chaired by Robert Schafermeyer, MD.

SAEM appreciates the opportunity toprovide comments on the proposedchanges in regulations under theEmergency Medical Treatment andLabor Act (EMTALA) as noted in theproposed FY 2003 Medicare InpatientPPS Rule published in the FederalRegister on May 9, 2002.

It is obvious that the regulatory lan-guage has been thoughtfully reviewedby CMS and the proposed changesmore closely reflect the original intent ofCongress. SAEM is pleased with manycommon sense proposals that clarifythe definitions and demonstrate CMS’efforts to respond to physician concernsregarding EMTALA compliance.

EMTALA was passed in 1986 prima-rily in response to concerns that somehospitals across the country were refus-ing to treat indigent and uninsuredpatients or inappropriately transferringthem to other hospitals solely for eco-nomic reasons. The intent of the law --to ensure that all individuals receivenecessary emergency care regardlessof their ability to pay or insurance status-- is consistent with the mission of aca-demic emergency physicians and hospi-tal emergency departments as integralcomponents of America’s health caresafety net. SAEM believes that CMSshould provide very clear guidance as towhen EMTALA requirements are metand where other, more appropriate, fed-eral or state requirements prevail.

SAEM supports many of the refine-ments to the regulations, but has contin-uing concerns with a number of issues,some of which are included in the pro-posed regulatory changes, and somewere not addressed at all.

Many of the proposed definitions aregreatly improved; others would benefitfrom some additional changes and/orclarifications.Comes to the emergency depart-ment. SAEM generally supports thedraft regulation’s narrowed definition ofan emergency department, confining itto an area, whether located on or off thehospital’s main campus, that is speciallyequipped and staffed to render initialevaluation and treatment of emergencymedical conditions. However, the defini-tion should not include the statementregarding the significant amount of timea facility is used for emergency screen-ing and treatment. It is the nature of careprovided that distinguishes it as a dedi-cated emergency department and the

amount of time it is used is not relevant. Individuals who present to the ED

are described in the proposed regula-tions as "not ‘patients’ (of the hospital)who request an examination or treat-ment or have such requests made ontheir behalf." The proposal goes on todefine a request to exist if a "prudent layperson observer" believes that the indi-vidual needs examination or treatment.An EMTALA obligation is triggered by apatient-generated request and SAEMrecommends that CMS substitute theterm "obvious implied request" insteadof relying on perceptions of a prudentlay person to speak for patients that areunable to articulate their needs. Hospitalpersonnel must be made aware of theindividual’s presence and observe theappearance and/or behavior of that per-son in order to respond appropriately.All hospitals need policies that describesteps to be taken to ensure that a per-son in clear need e.g. a visitor who col-lapses in the cafeteria, receives the carethey need.

SAEM appreciates CMS’ recognitionthat some individuals who come to theED are not seeking a medical screeningexam to rule out a potential emergency.SAEM requests that only those individu-als requesting a "medical examination"be required to receive a medical screen-ing exam by a physician or other quali-fied medical personnel. Hospitalsshould have protocols for patients pre-senting with specified complaints whocan safely be seen and treated by des-ignated qualified medical personnel. Hospital property. SAEM is generallypleased with CMS’ clarifications of whatis considered hospital property forEMTALA purposes. In addition toexcluding structures on campus that arenot part of the hospital, the definitionincludes the main building, driveway,parking lot and sidewalk. This descrip-tion provides more precision for EMTA-LA purposes. The continued reliance onthe "250 yard" rule fosters unnecessaryambiguity and should be rescinded byCMS. For provider-based entitiesremote from the main hospital campus,CMS makes it clear that the responsibil-ity of the hospital is to have policies andprocedures in place to see that potentialemergencies are sent to the dedicatedED. Prior authorization. The proposed ruleimposes a new requirement that directsthe hospital to contact a

Medicare+Choice plan to obtain preapproval for post stabilization care forMedicare enrollees. It is difficult to iden-tify the precise moment of stabilizationin a busy ED, and with the currentdemands on most EDs today, manyhospitals initiate calls to insurers, bothcommercial and M+C plans for specialtyconsultation, follow-up care, and/or hos-pital admission. EDs often do notreceive timely responses from M+Cplans or the patients' primary carephysicians, with a few notable excep-tions, do not have policies in place toensure timely responses to ED calls.Such requirements and this lag inresponse time add to the already over-crowded conditions in the ED. SAEMbelieves that a regulatory mandate tocall M+C plans is unnecessary andunachievable in the current ED environ-ment.

SAEM believes that when a patientin the ED requests that care be provid-ed exclusively by his/her private physi-cian, and refuses examination or treat-ment by the emergency physician, theEMTALA obligation should be consid-ered discharged.On-call. There are practical limitationsfor busy medical specialists who main-tain their practice obligations and pro-vide on-call services for several differenthospitals where they have privileges.Unfortunately, the proposed regulationdoes not address the problem of ade-quate and timely specialty coverage.CMS regulatory language providesphysicians with more flexibility, whilecontinuing to impose the same level ofresponsibility on the hospitals to "main-tain an on-call list of physicians on itsmedical staff in a manner that bestmeets the needs of the hospital’spatients."

SAEM is very concerned with how"best meets the needs" will be interpret-ed and recommends that regulatory lan-guage recognize capability limitationsand substitute language from the statutewhich states that "the hospital must pro-vide for an appropriate medical screen-ing examination within the capability ofthe hospital’s emergency depart-ment…".

While the additional CMS guidanceof June 13, 2002 is useful in clarifyingthat simultaneous call is permitted andthat surgeons may schedule electivesurgery while on-call, it does not resolve

(continued on page 9)8

9

the basic and significant dichotomybetween increased flexibility for on-callphysicians and strict enforcement of thelaw on facilities. This issue will continueto worsen as physicians weigh the risksof on-call against the potential benefits.We recommend as does the AmericanCollege of Emergency Physicians that:

� Since EMTALA essentially is a non-discrimination law, SAEM believes thatif the hospital maintains an on-call listand offers services to everyone whocomes to the ED in a non-discriminato-ry fashion, it has met EMTALA obliga-tions, within the limits of its capabilities.

� CMS should clarify its commitment, inthe regulations, to a more equitable bal-ance between the potential medicalbenefits of a transfer to another facility,where a more appropriately trained spe-cialist is available, versus the risks ofremaining in a hospital where the skillsand experience of the local on-callphysician may not be ideal for the serv-ices required by the patient. This wouldplace greater reliance on the transfer-ring physician’s clinical judgement as tothe patient’s immediate needs. Thiscommitment on CMS’ part shouldextend to specialty physician offices aswell, where an ever growing number ofmedical services can be rendered safe-ly and efficiently. This affirmative clarifi-cation would yield the added benefit oflimiting the amount of time on-call physi-cians spend traveling to the hospital forrelatively minor needs. A commonsense analysis of clinical risks and ben-efits also should be an integral part ofthe improved training of state andregional office staff.

� CMS should support the goal of ade-quate medical specialty coverage byfacilitating regional planning and inter-hospital agreements for coverage. Thisissue should be on the agenda of anEMTALA advisory committee proposedlatter in this document. Applicability. A major concern of physi-cians and hospitals is when are EMTA-LA obligations satisfied? The originalintent of the EMTALA law was to imposeresponsibility on hospitals to providemedical evaluation for individuals whorequest it and prevent patients frombeing improperly transferred before sta-bilization. EMTALA was never intendedto extend to inpatients (where a dutyalready exists) who are admittedthrough the ED. The proposed rulestates that the EMTALA duty extends toan unstabilized admitted patient. The

proposal goes on to say that if an admit-ted patient is stabilized (which is docu-mented in the medical record) and laterdecompensates, the duty to treat is gov-erned by the hospital conditions of(Medicare) participation. Further, anelective (non-emergency) admissionwho becomes unstable also falls underconditions of participation, not EMTALA.

Regulating care by how the patient isadmitted is fundamentally flawed andexacerbates the confusion about whenthe EMTALA duty has been met. Werequest that CMS simplify the issue bycreating a sharp delineation that EMTA-LA applies to any patient who comes tothe ED and for whom a request foremergency care is made, until thatpatient is stabilized or admitted. Oncethe emergency physician has deter-mined that the patient needs to beadmitted, "conditions of participation"apply whether the patient is admittedthrough the emergency department,outpatient department, or is admitted onan emergency basis directly from a doc-tor’s office to surgery or a critical careunit. Patients are protected not onlyunder conditions of participation, but bystate laws, JCAHO-required hospitalpolicy, and other standards of care. TheEMTALA law was enacted to addressnon-discriminatory access to ED servic-es, not to the outcome of inpatient serv-ices. Additional recommendations

Several of the proposed regulatorychanges will foster a more sensible useof scarce ED resources. However, sig-nificant EMTALA compliance burdensremain unaddressed. Uneven enforce-ment and the absence of a mechanismfor ongoing input from the physician andhospital community leave us very con-cerned about the benefits of the pro-posed changes. SAEM strongly sup-ports additional steps that CMS shouldmake, as outlined by the AmericanCollege of Emergency Physicians: � Enforcement. Emergency physiciansand other medical specialists recognizethat EMTALA definitions are legal ratherthan clinical, and urge CMS investiga-tors to focus on whether the medicalscreening examination process isapplied in a discriminatory manner, notwhether the reviewer has any quality ofcare concerns. ACEP and SAEM rec-ommend the following: 1) peer review,by an emergency or same specialtyphysician who is well-trained and knowl-edgeable about the EMTALA statute,and applies standards that assess dis-

crimination issues rather than solelymedical outcome, be mandatory andprompt; 2) the regulations include aprohibition on removing peer reviewdocuments from the institution to avoidsubverting state peer review privacydue to differing rules of evidence at thestate and federal levels; 3) the results ofpeer review be shared immediately withthe physician and/or hospital so a time-ly refutation or compliance plan can beprepared; and 4) physicians and hospi-tals be notified when the investigation iscomplete, regardless of the outcome,thus potentially avoiding unnecessaryexpenses.

� Consider deemed compliance withEMTALA in the face of a multi-casualtydisaster where the ED and hospital areresponding using community-developedprotocols.

� Work with CMS to develop modelcompliance/safe harbors so practition-ers have more surety about what is andis not considered compliant.

� Develop or support data collection toquantify the uncompensated care coststo physicians of EMTALA-mandatedcare and factor those costs into thepractice expense component of theMedicare fee schedule.

� Advisory group. ACEP rand SAEMrecommend that CMS appoint anEMTALA advisory group or committeecomprised of emergency physiciansand other EMS first responders, medicalspecialties, nurses, as well as hospitalsto address the need to finance thisunfunded mandate. After more than 15years, the resiliency of the emergencycare system and good will of providersis in jeopardy, and federal policy mustbe developed to address funding foruncompensated care with respect toEMTALA-mandated services, as well asto provide broader-based approaches toon-call coverage, EMS infrastructure,and EMTALA enforcement.

SAEM appreciates the opportunity toprovide input on these important issues.SAEM will work with CMS to ensure thatEMTALA requirements are reasonableand treat all healthcare providers fairly,do not detract from patient care, northreaten an important component ofAmerica’s health care safety net – thenation’s emergency departments. TheSociety for Academic EmergencyMedicine thanks the Centers forMedicare and Medicaid Services forconsideration of SAEM's views.

Changes in EMTALA (Continued)

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Academic AnnouncementsSAEM members are encouraged to sub-mit Academic Announcements on pro-motions, research funding, and otheritems of interest to the SAEM member-ship. Submissions should be sent tosaem@saem.org by September 1 to beincluded in the September/Octoberissue.

Charles K. Brown, MD, has been pro-moted to Professor of EmergencyMedicine at The Brody School ofMedicine at East Carolina University.Dr. Brown has also been the director ofthe Emergency Medicine residency pro-gram since 1993.

Frederick M. Burkle, Jr, MD, MPH, hasbeen appointed Deputy AssistantAdministrator, Bureau for Global Health,U.S. Agency for InternationalDevelopment at the Department ofState. Dr. Burkle was formerly SeniorScholar, Scientist and VisitingProfessor, Departments of EmergencyMedicine and International Health,Center for International Emergency,Disaster and Refugee Studies at theJohns Hopkins University.

Joseph Clinton, MD, will lead the newDepartment of Emergency Medicine atthe University of Minnesota. The newdepartment is the culmination of effortsbetween the University of Minnesotaand Regions Hospital and will haveapproximately 45 faculty from bothHennepin County Medical Center andRegions Hospital. Dr. Clinton is current-ly also chief of emergency medicine atHennepin.

Michael Gibbs, MD, has become Chairof the Department of EmergencyMedicine at Maine Medical Center. Hebecame chair on August 1.

Parker Hays, MD, has been namedEmergency Medicine ResidencyDirector at Carolinas Medical Center.

Debra Houry, MD, MPH, assistant pro-fessor, Emory University, and associatedirector of Emory’s Center of InjuryControl, will be honored with the 2002Jay Drotman Award from the AmericanPublic Health Association. The highlycompetitive award recognizes an out-standing young public health researcherunder 30 years of age who has demon-strated potential in the health field bychallenging traditional public health pol-icy or practice in a creative and positivemanner.

Charlene Irvin, MD, Catherine Marco,MD, and Jeff Kline, MD, have beennamed Associate Editors of AcademicEmergency Medicine. Dr. Irvin is theResearch Director at St. John Hospitaland Medical Center and an AssistantClinical Professor at Wayne StateUniversity. Dr. Marco is an AssociateProfessor of Surgery at the MedicalCollege of Ohio and an attending physi-cian at St. Vincent Mercy MedicalCenter in Toledo. Dr. Kline is theDirector of Research at CarolinasMedical Center and an AssistantProfessor of Emergency Medicine at theUniversity of North Carolina, Chapel Hill.

Jennifer Isenhour, MD, was namedassistant Emergency Medicine

Residency Director at CarolinasMedicine Center and assumed herduties on August 1.

Linda Lawrence, MD, has been select-ed to be the Commandant for theUniformed Services University of theHealth Sciences (USUHS) School ofMedicine in Bethesda, Maryland. Dr.Lawrence, a Lt. Col. in the U.S. AirForce, is an Associate Professor in theDepartment of military and EmergencyMedicine. She is also the first emer-gency physician to hold this position.

Robert E. O’Connor, MD, MPH, hasbeen promoted to Professor ofEmergency Medicine at ThomasJefferson University. Dr. O’Connor isDirector of Education and Research atChristiana Care Health System inNewark, Delaware.

Jon Olshaker, MD, has been appointedProfessor and Chair of the Departmentof Emergency Medicine at BostonUniversity School of Medicine and Chiefof the Department of EmergencyMedicine at Boston Medical Center.Previously Dr. Olshaker was Professorof the Division of Emergency Medicine,Department of Surgery at the Universityof Maryland and Director of EmergencyCare Services at the Veterans AffairsMedical Center in Baltimore.

Christina L. Schenarts, MD, has beennamed Assistant Residency Director forthe Emergency Medicine ResidencyProgram at The Brody School ofMedicine at East Carolina University.

The Top 5 Most-Frequently-Read Contents of AEM – June 2002Most-read rankings are recalculated at the beginning of the month. Rankings are based on hits received by articlesarchived on AEMJ.org.

Validation of the Canadian Clinical Probability Model for Acute Venous Thrombosis Acad Emerg Med Jun 01, 2002 9: 561-566. (In "CLINICAL INVESTIGATIONS")

Droperidol--Behind the Black Box WarningAcad Emerg Med Jun 01, 2002 9: 615-618. (In "COMMENTARIES")

Evaluation of Guidelines for Ordering Prothrombin and Partial Thromboplastin TimesAcad Emerg Med Jun 01, 2002 9: 567-574. (In "CLINICAL INVESTIGATIONS")

Scientific Priorities and Strategic Planning for Resuscitation Research and Life Saving TherapyFollowing Traumatic Injury: Report of the PULSE Trauma Work GroupAcad Emerg Med Jun 01, 2002 9: 621-626. (In "SPECIAL CONTRIBUTIONS")

Parents and Practitioners Are Poor Judges of Young Children's Pain SeverityAcad Emerg Med Jun 01, 2002 9: 609-612. (In "CLINICAL PRACTICE")

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ABEM Call for Nominations As a sponsoring organization of the American Board of Emergency Medicine (ABEM), SAEM will develop a slate of nominees

to submit to the ABEM Nominating Committee for consideration of the three or four seats that will be filled by election by theABEM Board at its winter 2003 Board meeting. SAEM members wishing to be considered for the SAEM slate of nominees areinvited to send a nomination to SAEM at saem@saem.org.

Nominations should include a current copy of the nominee’s curriculum vita, as well as a cover letter outlining the nominee’squalifications. The deadline is September 6, 2002.

The SAEM Board of Directors will review all nominations and submit a slate of nominees to ABEM by December 1, 2002.Successful candidates are expected to be members of SAEM with considerable experience in SAEM and academic EM, as wellas experience in ABEM. The SAEM Board does not nominate current members of the SAEM Board for consideration. In addi-tion, ABEM has established the following criteria for nominated physicians:

� Be a graduate of an ACGME-accredited EM residency program.� Be an ABEM diplomate for a minimum of ten years.� Have demonstrated extensive active involvement in organized EM. Ideally, this includes long-term experience as an ABEM

item writer, oral examiner, or ABEM-appointed representative.� Be actively involved in the clinical practice of EM.

Physicians selected for the SAEM slate of nominees will be notified in October or November and will be required to submitthe official ABEM nomination form, curriculum vita, and letter noting their willingness to serve if elected.

It is important to note that all organizations and individuals are invited to participate in the ABEM nomination process and fur-ther information can be obtained through the ABEM web site at www.abem.org. This Call for Nominations is published for theexpress purpose of developing the official SAEM slate of nominees.

Emory University Secures Three Year NIH Award About Treatment ofTraumatic Brain Injury

Junaid A. Razzak, MDYale UniversitySAEM Research Committee

The Department of EmergencyMedicine at Emory University recentlysecured a RO1 research grant from theNational Institutes of Health (NINDS) fortheir study entitled "Progesterone treat-ment of blunt traumatic brain injury". Itis a three-year, randomized, double-blinded placebo-controlled clinical trialwith three main goals: (1) to determinethe safety of progesterone when givenintravenously over three days, (2) todetermine the pharmacokinetics of thedrug in humans, and (3) to look for evi-dence of its efficacy in patients withtraumatic brain injury (TBI). Dr. ArthurKellerman, chairman of EM at Emory, isthe principal investigator for this study;however, he is of the opinion that secur-ing and implementing the grant wouldnot have been possible without theefforts and commitment of David Wright,MD.

Dr. Wright is a graduate of Universityof Alabama (UAB) Medical School andreceived his postgraduate training at theUniversity of Cincinnati emergencymedicine residency program. He citesseveral past experiences as beinginstrumental towards securing thisaward. During his time at UAB hesecured a Howard Hughes fellowship

that enabled him to spend some time ina basic science lab. Dr. Wright joinedEmory upon completing his residency,with a clear departmental expectationthat he would focus on research. Dr.Wright sought a partnership with DonaldStein, PhD, professor of neurology andpsychobiology and dean of the EmoryUniversity Graduate School of Arts andSciences. Dr. Stein, who is recognizedfor his expertise in the area of brainrepair and recovery following neurotrau-ma, was also looking for a clinical col-laborator. Thus Dr. Wright was able tobenefit from Dr. Stein’s lab and to gainexpertise about research in the area oftraumatic brain injury.

Dr. Wright subsequently applied for asmall intramural grant from Emory tolook for the differences in TBI amongmen and women. The SAEM scholarlysabbatical grant in 1999 came as amajor turning point in his career. Thesabbatical allowed him to buy down hisclinical time for six months and use thattime to study the dose-response rela-tionship of progesterone in an animalmodel. During that time he was alsoable to create and lead a multi-discipli-nary interest group comprised of fivedepartments (emergency medicine,

neurology, neurosurgery, trauma sur-gery, and rehabilitation medicine) andthree schools (Emory University Schoolof Medicine, Morehouse School ofMedicine and Rollins School of PublicHealth). The idea and support for theNIH funded clinical trial came directly asa result of discussions and collaborationbetween group members.

The conception and initial writing ofthe project started more than threeyears before the grant was secured.The proposal was not funded on its ini-tial review, but was funded after revi-sion. Dr. Wright identified mentorshipboth within the department (Dr.Kellerman, Dr. Lowery) and outside thedepartment (Dr. Stein) as well initialsupport from the Emory’s intramuralgrant and SAEM sabbatical grant asmain factors for his success in securingthis grant.

This award has had significantimpact on the whole department. Fourfaculty members in EmergencyMedicine now have protected researchtime. The department was able to hire afull-time research nurse and an epi-demiologist. They have helped in otherprojects and the department has subse-quently been able to secure many other

More Annual Meeting Highlights

12

Members of the Board and the past presidents met during the annual Past Presidents' Breakfast. (Front L-R)Sandra Schneider, MD, Roger Lewis, MD, PhD, Mary Ann Schropp (executive director), Bill Barsan, MD, JohnMarx, MD, and Marcus Martin, MD. (Back L-R) Art Sanders, MD, Dave Sklar, MD, Lewis Goldfrank, MD, SteveDavidson, MD, Jim Niemann, MD, Don Yealy, MD, Brian Zink, MD, Joe Waeckerle, MD, Louis Binder, MD, KendallMcNabney, MD, and Louis Ling, MD.

Dr. Martin congratulates some of the 2001 Annual Meeting poster/paperaward recipients who received formal acknowledgment during the AnnualBusiness Meeting. (L-R) Henry E. Wang, MD, Marcus Martin, MD, RaymondRegan, MD, Bret Rogers, and Alex Limkakeng.

Kristi Koenig, MD, introduced Scott R. Lillibridge, MD,Special Assistant to the Secretary for National Securityand Emergency Management. Dr. Lillibridge presented awell-received lunch session on May 22.

Bob Niskanen ofMedtronic Physio

Control congratulatesJason Borton, MD,the recipient of the

2002-2003 EMSResearch Fellowship

Grant.

Joe LaMantia, MD,received the CORDImpact Award for hiswork coordinating the2002 CORD CoreCompetenciesConference.

13

The Program Committee did an extraordinary job planning the 2002 Annual Meeting. (Back L-R) Sue Stern, John Flaherty, Susan Promes,Dane Chapman, Diane Gorgas, Ellen Weber (Chair), Todd Larabee, Cathy Custalow, Mary Jo Wagner, Gary Vilke, Greg Garra, and BrianEuerle. Front (L-R) Terry Vanden Hoek, David Lee, Richard Shih, Jack Kelly, Adam Singer, David Guss, and Chris Barton.

Dr. Martin welcomed past presidents of SAEM (and UAEM) at the Annual Meeting Banquet. (L-R) Dr. Martin, Mary Ann Schropp (SAEM exec-utive director), Louis Ling, MD, Dave Sklar, MD, Steve Davidson, MD, Bill Barsan, MD, Lewis Goldfrank, MD, Sandra Schneider, MD, KendallMcNabney, MD, Jerris Hedges, MD, Joe Waeckerle, MD, and Art Sanders, MD. Other past presidents who attended the Annual Meeting includ-ed: Louis Binder, MD, John Marx, MD, Jim Niemann, MD, Richard Nowak, MD, and Brian Zink, MD.

Dr. Martin congratulates DebraHoury, MD, MPH, on the comple-tion of her one-year term as theresident member of the SAEMBoard.

CORD unveiled a new award in St.Louis to recognize program direc-tors who have served 10, 15, and

20 years. Pictured are Sal Vicario,University of Louisville, and Gwen

Hoffman, Spectrum Health in GrandRapids, Michigan. Both have

served as program directors for 20years. Photos of other recipients

will be published in the CORDNewsletter.

14

President’s Message (Continued)

rank…". So, if we accept the fact that women

are entering the ranks of academics insubstantial numbers, but are less likelyto advance in rank, it is important tounderstand the barriers to advancementthat women face in academic medicine.In 2001, Yedidia et al4 interviewed lead-ers in clinical academic departmentsregarding their views on the barriersconfronting women in academic medi-cine. The study population included 34department Chairs and two DivisionChiefs in five clinical specialties. In theopinions of these academic leaders,women primarily faced three barriers toadvancement: 1) the constraints of tra-ditional gender roles (e.g., time spent inchild bearing and raising young chil-dren); 2) "sexism in the medical environ-ment;" and 3) a "lack of effective men-tors." Without intending to minimize theimportance of gender roles and sexismas barriers to advancement, I would liketo spend the rest of this column focusingon the third barrier: the lack of effectivementorship for women pursuing careersin academic medicine.

The goal of mentorship is to facilitatethe acquisition of knowledge and aca-demic skills required for long-term aca-demic success and productivity. Inorder to explore the relationshipbetween mentorship and gender further,it is necessary to make some general-izations. Although there are, of course,many exceptions to any generalizationregarding gender, considering somegeneralizations may lead to furtherinsights on the interaction betweenmentorship and gender.

Deborah Tannen, a linguist who hasextensively studied the interactionbetween gender and language,describes two styles of interaction.5,6

According to Tannen, a typically mascu-line interactive style involves negotiationof status or rank within a hierarchy (i.e.,is competitive).5 The important "curren-cies" when one uses a masculine styleare rank and power. In contrast, a typi-cally feminine interactive style empha-sizes cooperation and the minimizationof differences (i.e., is cooperative).5

With this style social harmony, commu-nication, and connectedness are theimportant currencies.

Most formal academic interactions,such as faculty meetings and the ques-tioning of lecturers after a presentation,are conducted in a competitive style. Inthis type of setting, the contributions of

faculty who choose to use a cooperativestyle are often not noticed. For exam-ple, many women find that their intellec-tual contributions in group academicsettings (e.g., faculty meetings) are sub-sequently attributed to men who makesimilar but derivative comments. [If youare male and find this difficult to believe,please ask one of your female col-leagues.] There are a wide variety ofacademic settings in which the accurateattribution of intellectual contributions isimportant. For example, the order ofauthorship on research manuscriptsshould accurately reflect the relativeintellectual contributions and work prod-uct of the authors, especially sinceauthorship position is often consideredby promotion and tenure committeesevaluating one’s publication record.Faculty members using a cooperativestyle, generally women, have greaterdifficulty garnering the recognition,respect, and support of colleagueswhich is necessary for career develop-ment and academic promotion.

The first step in effectively address-ing this type of subtle and unintentionalgender bias is acknowledging that itexists. Since it does exist, effectivementorship requires addressing theissue, for example by helping those witha cooperative style to recognize thosesituations in which they may want toadjust their strategy. Whether or not acooperative style should be as effectivein academic settings as a competitiveone is not the question—the question iswhether the mentor acknowledgesthese issues and teaches the menteeeffective strategies. This is analogousto the question of whether or not toteach a resident how to deal with difficultpatients (e.g., patients with addictions orpersonality disorders). Although we allwish such patients were less frequent,any comprehensive training programincludes instruction on strategies foroptimizing the care of patients with per-sonality disorders, addictions, and simi-lar problems.

De Angelis noted in her editorial that"…mentors are more important than rolemodels."2 It is often noted that an inad-equate number of women in senior aca-demic positions are available to serveas role models for women in junior fac-ulty positions. Thus, if women are tofind senior faculty to help guide them intheir career and skill development,many will need to form mentor-menteerelationships with men. Dr. De Angelis

goes on to state that [my italics]:2

"Mentoring is also a very difficultproblem to resolve, because men-tors are generally senior facultymembers, and relatively few seniorfaculty members are women. …Although women do not necessarilyneed women mentors, men havenot yet come forward to a degreenecessary to make much differ-ence. Also, the approach to men-toring women can be different fromthat for mentoring men. For exam-ple, women often do better thanmen in collaborative ventures, butthey must be taught how to protectthemselves from being exploited."

The mentor is often in a position toensure that a junior faculty’s contribu-tions are appropriately noticed. Forexample, in a group setting the mentormay redirect questions to the mentee, toensure that all are aware of thementee’s expertise. In addition, if thementor is asked about research whichthey are conducting collaboratively, thementor should redirect the electronicmail or telephone call directly to thementee, again to assure that the intel-lectual product is attributed to the juniorfaculty member. Such actions alsodemonstrate the mentor’s confidence inthe mentee’s ability to explain their jointwork, which gives further credibility tothe junior faculty member.

There are many settings in which acollaborative approach to academicactivities may be more productive than acompetitive one. For example, muchhealth services research and clinical tri-als research requires the collaborationof many investigators, from multiplestudy sites, working towards a singlegoal. In such settings, a typically femi-nine style is probably preferable to amasculine one.

It is difficult to overstate the impor-tance of a strong mentor-mentee rela-tionship in the career development ofresearch fellows and junior faculty mem-bers. Because women in junior facultypositions face different barriers to theiradvancement than men, and the pri-mary goal of the mentor is to fully pre-pare the junior faculty member to ensuretheir future career success, it is impor-tant that the mentor both acknowledgeand address these challenges. Sincetoo few senior women in academic posi-tions are available to serve as both men-

(continued on page 15)

15

President’s Message(Continued)

tors and role models for women enteringacademics, senior male faculty mem-bers must rise to the challenge and pro-vide both support and guidance, tailoredto the specific challenges women face inacademic medicine.

References

1. Nonnemaker L. Women Physiciansin Academic Medicine. New EnglandJournal of Medicine 2000;342:399-405.

2. De Angelis CD. Women in AcademicMedicine: New Insights, Same SadNews. New England Journal ofMedicine 2000;342:425-427.

3. Cydulka RK, D’Onofrio G, SchneiderS, Emerman CL, Sullivan LM, onBehalf of the SAEM Women andMinorities Task Force. Women inAcademic Emergency Medicine.Academic Emergency Medicine2000;7:999-1007.

4. Yedidia M, Bickel J. Why Aren’tThere More Women Leaders inAcademic Medicine? The Views ofClinical Department Chairs.Academic Medicine 2001;76:453-465.

5. Tannen D. You Just Don’tUnderstand: Women and Men inConversation. New York: Ballantine,1990.

6. Tannen D. Talking from 9 to 5.Women and Men in the Workplace:Language, Sex and Power. NewYork: Avon, 1994.

EMF Grants AvailableThe Emergency Medicine Foundation (EMF) grant applications are available onthe ACEP web site at www.acep.org. From the home page, click on "AboutACEP," then click on "EMF," then click on the "EMF Research Grants" link for acomplete listing of the downloadable grant applications. The funding period forall grants is July 1, 2003 through June 30, 2004, except for the Congestive HeartFailure Award which will be funded for January 1, 2003 through December 31,2003.

Directed Research Acute Congestive Health Failure AwardThis grant is sponsored by EMF and Scios, Inc. This request for proposals

specifically targets research that is designed to improve the care for patients whopresent to the ED with acute congestive heart failure. Only clinical science pro-posals will be considered. Proposals may focus on methods of facilitating treat-ment through early diagnosis, intervention and treatment of acute congestiveheart failure patients. Deadline: September 20, 2002. Notification: November4, 2002.

Riggs Family Health Policy Research GrantBetween $25,000 and $50,000 for research projects in health policy of health

services research topics. Applicants may apply for up to $50,000 for a one or twoyear period. Grants are awarded to researchers in the health policy or healthservices area who have the experience to conduct research on critical health pol-icy issues in emergency medicine. Deadline: December 20, 2002. Notification:March 2003.

Resident Research Grant A maximum of $5,000 to a junior or senior resident to stimulate research at the

graduate level. Deadline: December 20, 2002. Notification: March 2003.

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

assistant professor level who needs seed money or release time to begin a prom-ising research project. Deadline: January 15, 2002. Notification: March 2003. Research Fellowship Grant

A maximum of $75,000 to emergency medicine residency graduates who willspend another year acquiring specific basic or clinical research skills and furtherdidactic training research methodology. Deadline: January 15, 2002.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 grantprogram is to fund research on towards acute disorders of the neurological sys-tem, such as the identification and treatment of diseases and injury to the brain,spinal cord and nerves. $50,000 will be awarded annually. Deadline: January15, 2003. Notification: March 2003.

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

Medicine (SAEM). A maximum of $2,400 over 3 months is available for medicalstudents to encourage research in emergency medicine. Deadline: February 3,2003. Notification: March 2003.

Keep YourMembership

Mailings Coming!Be sure to keep the SAEM officeinformed of changes in youraddress, phone or fax numbers,and especially your e-mail address.SAEM sends infrequent e-mails toSAEM members, but only regard-ing SAEM issues or activities.SAEM does not sell or release itsmailing list or e-mail addresses tooutside organizations. Send updat-ed information to saem@saem.org

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Opportunities Through the AACEM Consult ServiceGlenn Hamilton, MDWright State UniversityChair, AACEM Consulting Service

Since the Association of AcademicChairs in Emergency Medicine(AACEM) was founded in 1989, theConsult Service of the Association hashad an active role. The primary focus ofthis service is to assist academic med-ical centers in establishing academicdepartments of emergency medicine inthe United States and Canada. Theservice has had a contributing role inthe development of several depart-ments and is currently at various stagesof discussion with three or four sitesconsidering this important decision.The AACEM and SAEM ConsultServices have worked closely together.

The Consult Service’s activitiesinclude: 1. Overview assessment of the status

of emergency medicine in an aca-demic medical center to determinethe suitability and timing for evolv-ing to academic departmental sta-tus.

2. Assisting divisions or other institu-tional entities in developing a pro-posal for development of an aca-demic department in the institution.

3. Site surveys to assist the division aswell as the Dean’s office and hospi-tal administration in their decision

making regarding the potential andappropriate time table for develop-ment of an academic department.

4. Discussions at any level of decisionmaking with emergency medicineleadership about the approach,negotiations, documentation andtimeframe of developing an aca-demic department.

The actual consultation consists oftwo current Academic Chairs ofEmergency Medicine who are selectedconjointly by the consult service and theinstitution. These Chairs usually spendtwo days at the site and develop areport regarding the specific questionsasked of them. Current fees for thisservice are $1,500 per individual perday plus overnight expenses. In addi-tion, $500 is contributed to AACEM foradministrative purposes.

One significant accomplishment ofthe service was to develop a mono-graph entitled “Establishing theAcademic Department of EmergencyMedicine: Commentary on Five Phasesof Development”. The monographreviews the five major phases of devel-opment beginning five years before andcontinuing five years after the actualestablishment of an academic depart-

ment. This useful monograph is avail-able from the AACEM Office throughSAEM Administrative Offices.

Currently, the consult service isdeveloping a listing of current sites thatmay have the potential for evolving fromtheir current institutional status into aformal Academic Department ofEmergency Medicine. Contacts withindividuals in emergency medicine atthese sites will be made over the nextseveral years.

Emergency Medicine essentiallydoubled its number of academic depart-ments in the 1980’s and doubled thatnumber again in the 1990’s. Currently,there are 63 academic departments inthe United States in 124 medicalschools. This leaves the opportunity forone more doubling to ensure the com-plete integration of emergency medicineinto academic medicine throughout thecountry.

Please contact me if you may havean interest in discussing the potential ofan academic Department of EmergencyMedicine at your institution. The full tal-ent and capability of the AACEM isdirected toward this most importantgoal.

Call For NominationsYoung Investigator Award

Deadline: December 13, 2002In May 2003, SAEM will recognize a few young investigators who have demonstrated promise and distinction in their emer-

gency medicine research careers. The purpose of the award is to recognize and encourage emergency physicians/scientists ofjunior academic rank who have a demonstrated commitment to research as evidenced by academic achievement and qual-ifications. The criteria for the award includes:

1. Specialty training and certification in emergency medicine or pediatric emergency medicine.2. Evidence of significant research collaboration with a senior clinical investigator/scientist. This may be in the setting of a col-

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

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

The deadline for the submission of nominations is December 13, 2002, and nominations should be submitted electronically tosaem@saem.org. Nominations should include the candidate’s CV and a cover letter summarizing why the candidate merits con-sideration for this award. Candidates can nominate themselves or any SAEM member can nominate a deserving young investiga-tor. Candidates may not be senior faculty (associate or full professor) and must not have graduated from their residency programprior to June 30, 1996.

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

SAEM

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Call for PapersAEM 2003 Consensus

Conference: Disparities in EDHealth Care

Deadline: March 1, 2003

The Editors of Academic Emergency Medicineannounce the 2003 AEM Consensus Conference on"Disparities in Health Care" to be held on May 28, 2003in Boston, the day before the SAEM Annual Meeting.Disparities in health care are likely to present both withinthe ED decision making process and in the largerhealthcare system. The US emergency departmentsmight be important sources of information about bothfacets. However, disparities need to be recognized inorder to be addressed.

Do inequalities exist in our treatment of emergencypatients? If so, under what circumstances, at what leveland for what reason? In the larger healthcare systemthere is evidence that people of color and women do notalways receive the same level of care. Are suchdisparities real? When, why, how, do disparities occur?Who is at risk of receiving less than optimal care? Whatis the degree of disparity? How can disparity beeliminated? In a larger sense, what are the best ways topromote a highly reliable system of low variability? Dowe teach our residents to deliver disparate care? Howdoes the greater healthcare system contribute to real orperceived disparities in ED management? Aredisparities sometimes due to systems incompetence? Isthere a relationship between the degrees of inequalityand degrees of system incompetence? How can westudy these questions? What measures can be used?Most emergency physicians assume that there shouldbe no disparities in health care. If the general publicholds this believe as well, why has our society has notinsisted upon the development of an equitable system ofhealthcare?

The goals of the conference will be to examine thepresence, causes, and outcomes related to disparities ofhealthcare as they occur in emergency departments,and determine the degree to which forces from outsidehave an impact on our patients. The conference will aimto describe means of defining, assessing, measuring,and researching disparities that may occur inemergency care. The hope is to establish a researchagenda for further assessment of these, and otherrelated questions. The conference is a logicalprogression in the AEM consensus series, which hasincluded "Errors in Emergency Medicine," "TheUnraveling Safety Net, " and " Assuring Quality."

We therefore issue this Call for Papers related to thetopic of Disparities in ED Health Care. Submittedmanuscripts must be received at the AEM editorialoffice by March 1, 2003. Electronic submission toaem@saem.org of the original and a blinded copy isrequired. Also include a cover letter indicating that thesubmission is in response to this Call. Accepted paperswill be published in the late fall of 2003, along withProceedings from the Consensus Conference.Questions can be directed to Michelle Biros(biros001@maroon.tc.umn.edu) or Jim Adams(jadams@nmh.org).

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 will be available on the SAEM website at www.saem.org in November. For further infor-mation or questions, contact SAEM atsaem@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.

18

SAEMMembership Application

Please complete and send to SAEM with appropriate dues, and supporting materials.SAEM • 901 N. Washington Ave. • Lansing, MI 48906 • 517-485-5484 • Fax: 517-485-0801 • www.saem@saem.org

Name ______________________________________________________________________ Title: MD DO PhD Other _________

Home Address _______________________________________________________________ Birthdate_________________ Sex: M F

___________________________________________________________________________________________________________

Business Address ______________________________________________________________________________________________

___________________________________________________________________________________________________________

Preferred Mailing Address (please circle): Home Business

Telephone: Home ( ______ ) ______________________________ Business ( ______ ) ______________________________

FAX: ( ______ ) _____________________________________ E-mail: ____________________________________________________

Medical School or University Faculty Appointment and Institution (if applicable): _________________________________________________

Membership benefits include:• subscription to SAEM’s monthly, peer-reviewed journal, Academic Emergency Medicine• subscription to the bimonthly SAEM Newsletter• reduced registration fee to attend the SAEM Annual Meeting

Check membership category: ❒ Active ❒ Associate ❒ Resident ❒ Fellow ❒ Medical Student

Active: individuals with an advanced degree (MD, DO, PhD, PharmD, DSc or equivalent) who hold a university appointment or are actively involvedin Emergency Medicine teaching or research. Annual dues are $365 payable when the application is submitted. The application must beaccompanied by a CV.I attest that I hold a university appointment or am actively involved in Emergency Medicine teaching or research: ❒ Yes ❒ No

Associate: health professionals, educators, government officials, members of lay or civic groups, or members of the public who have an interest inEmergency Medicine. Annual dues are $350 payable when the application is submitted. The application must be accompanied by a CV.

Resident: residents interested in Emergency Medicine. Annual dues are $90 payable when the application is submitted. My anticipated date(month and year) of residency graduation is_________. (A group discount resident member rate is available. Contact SAEM for details.)

Fellow: fellows interested in Emergency Medicine. Annual dues are $90 payable when the application is submitted. My anticipated date (monthand year) to complete my fellowship is_________.

Medical Student: medical students interested in Emergency Medicine. Annual dues are $75 (includes journal subscription) or $50 (excludesjournal subscription), payable when the application is submitted. My anticipated medical school graduation date (month/year) is _________.

Interest Groups: SAEM members are invited to join interest groups. Include $25 annual dues for each interest group (resident members may joinone interest group at no charge):

❒ airway❒ CPR/ischemia/reperfusion❒ clinical directors❒ diversity❒ domestic violence❒ EMS❒ ethics

❒ evidence-based medicine❒ geriatrics❒ health services & outcomes

research❒ injury prevention❒ international❒ medical student educators

❒ neurologic emergencies❒ pain management❒ pediatric emergency medicine❒ research directors❒ simulation❒ substance abuse❒ toxicology

❒ trauma❒ ultrasound❒ web-educators❒ youth violence prevention

My signature certifies that the information contained in this application is correct and is an indication of my desire to become an SAEM member.

Signature of applicant _______________________________________________________________________ Date ________________

NOTE:Join SAEM in the last quarter of2002 and receive membership

benefits for the rest of 2002 and all of 2003 with payment of one

year’s due payment.

NOTE:$25 initiation fees have been discontinued. Also, resident

members may select membership in one interest group at no charge.

19

FACULTY POSITIONSANN ARBOR, MI – FACULTY ACADEMIC/CLINICAL STAFF POSITION.Seeking BC/BP EM physician to join St. Joseph Mercy Hospital. Level IITrauma Center with on-site Medflight air ambulance service that sees 92,000patients annually between the ED, adult and pediatric ambulatory carecenters, and chest pain observation unit. Approved EM Residency programsponsored by hospital and U of M Medical Center. Employed positions offerexcellent remuneration plus faculty stipend, productivity bonus, paidmalpractice, relocation allowance, cafeteria-style benefits, 401(k), long-termdisability, flexible scheduling, and more. Contact Nancy Ely @ 800-466-3764, ext.337; nely@epmgpc.com; or visit us @ EPMGPC.com.

BROOKLYN, NEW YORK: Seeking a BC/BP physician to join the staff at TheBrooklyn Hospital Center. We offer a great working environment (85Kvisits/yr. and newly renovated ED in mid-2000) along with directinvolvement in our fully accredited EM residency-training program. The rightperson will be offered a competitive package and the opportunity to workwith a dynamic, collegial all BC staff. Send CV to: Lisandro Irizarry MDMPH, Chair Emergency Medicine, The Brooklyn Hospital Center, 121 DekalbAve. Brooklyn, NY 11201. Fax: 718-250-6528, phone 718-250-6889.

COOK 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 6335451 jschaider@ccbh.org

GEORGIA: MEDICAL COLLEGE OF GEORGIA: EMERGENCYULTRASOUND FELLOWSHIP. The Department of Emergency Medicine atthe Medical College of Georgia is offering a one-year fellowship inemergency ultrasound. The Medical College of Georgia is a level-one traumacenter with high volume and high acuity yielding ample pathology forbedside ultrasound diagnosis. The emergency department has threeultrasound machines, including a state of the art machine capable of tissueharmonics and 3-D imaging. The fellow will be exposed to a broad range ofemergency ultrasound applications and numerous ultrasound researchprojects with one of the most experienced and published emergencyultrasonographers in the country. Competitive salary. If interested pleasesend CV and cover letter detailing your interest to: Michael Blaivas, MD,RDMS, Department of Emergency Medicine, Medical College of Georgia,1120 15th Street, AF-2056, Augusta, GA 30912-4007. E-mail is preferred:blaivas@pyro.net

GEORGIA: MEDICAL COLLEGE OF GEORGIA. The Department ofEmergency Medicine has two openings for full-time Emergency Medicineattendings. Must be board certified or board eligible in emergency medicine.Established emergency medicine residency program with nine residents peryear. Spacious, new ED facilities. New contiguous children’s hospital andbeautiful pediatric ED. Over 67,000 visits per year. Level I trauma center forpediatric and adult patients. Augusta is an excellent family environment andoffers a variety of social, cultural and recreational activities. Compensationand benefits are excellent and highly competitive. Contact Larry Mellick,MD, Chair and Professor, Department of Emergency Medicine, 1120 15thStreet, AF 2036, Augusta, GA 30912; 706-721-6619,lmellick@mail.mcg.edu . EOE

NEW YORK – THE BROOKLYN HOSPITAL CENTER. is seeking applicationsfor Residency Director. We have a fully accredited PGY 1–4 residency andaccept 6 residents/year. We see 85,000 visits/year and boast a newlyexpanded department opened in mid 2000. Applicants must be boardcertified in EM and have previous experience in resident education andresearch. A competitive package along with an extremely collegialatmosphere will be offered to the right candidate. Qualified applicantsshould send a cover letter and CV to Lisandro Irizarry MD MPH, Chair, Deptof Emergency Medicine, The Brooklyn Hospital Center 121 Dekalb Ave.Brooklyn NY 11201

THE OHIO STATE UNIVERSITY: Assistant/Associate or Full Professor.Established residency training program. Level 1 Trauma center. Nationallyrecognized research program. Clinical opportunities at OSU Medical Centerand affiliated hospitals. Send curriculum vitae to: Douglas A. Rund, MD,Professor and Chairman, Department of Emergency Medicine, The OhioState University, 016 health Sciences Library, 376 W. 10th Avenue,Columbus, OH 43210 or call (614) 293-8176. Affirmative Action/EqualOpportunity Employer.

The Institute for InternationalEmergency Medicine and Health at

Brigham and Women’s Hospital and theDivision of Emergency Medicine atHarvard Medical School are nowaccepting applications for their

International Medicine Fellowship.

Fellowship involves:Two-year track combining clinical emergency medicine,international fieldwork and research project.Academic classes lead to a Masters Degree at the HarvardSchool of Public Health.Academic appointment at Harvard Medical School.Clinical emergency medicine at affiliated teaching hospitals.Participation in training of medical students and residents.Competitive salary, benefits, CME, international travel funds,and training course expenses. Opportunity to tailor experience to meet specific interest indisaster response, emergency medical systemsdevelopment, health education, human rights, healthemergencies, international public health, and refugee relief.

Requires:Residency Training in Emergency Medicine.Completion of application process, interview, and selection.

Inquiries should be sent to the fellowship director: Mark A.Davis, MD, Institute for International Emergency Medicineand Health, Department of Emergency Medicine, Brighamand Women’s Hospital, PBB-Ground Pike, 75 Francis St.,Boston, MA 02115, or by email to madavis@partners.org.

Phone (617)732-5813; fax (617)264-6848.

20

OREGON: The Oregon Health Sciences University Department ofEmergency Medicine is conducting an ongoing recruitment of talented entry-level clinical faculty members at the assistant professor level. Preference isgiven to those with fellowship training, experience in collaborative clinicalresearch, and writing skills. Please submit a letter of interest, CV, and thenames and phone numbers of three references to: Jerris Hedges, MD, MS,Professor & Chair, OHSU Department of Emergency Medicine, 3181 SWSam. Jackson Park Road, UHN-52, Portland OR 97201-3098.

QUINCY MEDICAL CENTER seeks board certified/prepared emergencyphysicians with outstanding clinical skills and an interest in teaching.Additional opportunity exists for a qualified candidate as EMS Director.QMC (31,000 visits/year) is an affiliate of Boston Medical Center and ateaching site for the Boston University EM residency program. Faculty willhave a BU academic appointment and opportunity to rotate to BostonMedical Center, the regions busiest Level I Trauma center. Please directinquires to: William Baker, MD, Assistant Chief EM, or Octavio Diaz, MD,Chief, Quincy Medical Center, phone: (617) 376-5549; E-mail:odiaz@quincymc.org. Affirmative action/equal opportunity employer.

UNC-CHAPEL HILL, 2 openings for either tenure-track or clinical trackphysicians. Rank/salary commensurate with experience. Successful tenure-track candidates will be Board Certified/Board Prepared in EmergencyMedicine and/or Pediatric Emergency Medicine with an interest in clinicalcardiology, neurosciences research, pediatric EM, and/or EMS medicaldirection. Clinical track faculty are expected to do clinical work only. UNCHospitals is a 665-bed Level I Trauma Center. The Emergency Departmentsees upward of 40,000 high acuity patients per year, is active in regionalEMS, ACLS/ATLS/BTLS education and has an aeromedical service. Send CVto Edward Jackem, MBA, Department of Emergency Medicine, CB #7594,Chapel Hill, NC 27599-7594. (919) 966-9500. FAX (919) 966-3049. UNCis an Equal Opportunity/ADA Employer.

THE UNIVERSITY OF CALIFORNIA, DAVIS, SCHOOL OF MEDICINE isrecruiting for a full-time faculty at the Assistant, Associate or Full Professorlevel, in the Division of Emergency Medicine and Clinical Toxicology. Aresidency-training program in emergency medicine began over 10 years agoand currently has 29 residents. The UCDMC Emergency Departmentprovides comprehensive emergency service as a Level I trauma center, aswell as a paramedic base station and training center. Candidates for thisposition must be board certified or eligible in emergency medicine, and beeligible for licensure in California. For consideration, a letter outlininginterests and experience, and curriculum vitae should be sent to RobertDerlet, MD, Chair, Emergency Medicine Search Committee, University ofCalifornia, Davis, Medical Center, 2315 Stockton Blvd., PSSB 2100,Sacramento, CA 95817. Alternatively, an e-mail to Kerry Geist, Manager,Division of Emergency Medicine at klgeist@ucdavis.edu will be accepted.This position will be open until filled, but applicants will not be acceptedafter 10/15/02. The University of California is an affirmative action/equalopportunity employer.

UNIVERSITY OF CALIFORNIA, IRVINE recruiting two new full-time faculty:1) Assistant or Associate Clinical Professor. Appointment in the clinicalscholar series possible. Board preparation or certification in EM required.Fellowship or advanced degree strongly desired. 2) Experienced EMresearcher. Appointment as Associate or Professor in Clinical Scholar series.Substantial protected time. Board certification in EM required. MPH, PhD orresearch fellowship/training strongly desired. UCI Medical Center is a 472-bed tertiary care hospital with all residencies. The ED is a progressive 33-bedLevel I Trauma Center with 46,000 patients, in urban Orange County.Collegial relationships with all services. Excellent salary and benefits withincentive plan. Send CV to Mark Langdorf, MD, MHPE, FACEP, UCI MedicalCenter, Route 128. 101 City Drive, Orange, CA 92868. UCI is an equalopportunity employer committed to excellence through diversity.

VANDERBILT UNIVERSITY: The Department of Emergency Medicine has anunexpected opening for a clinician-educator at a level commensurate withqualifications. Please consider joining our successful Department. We have1st and 4th year medical student rotations, a Level I Trauma Center,contiguous Pediatric and Adult ED’s, a superb residency and all the othercomponents of a well established program. We provide great benefits andNashville is a great city. Please reply to Corey M. Slovis, M.D., Chairman,Department of Emergency Medicine, Vanderbilt University, 703 OxfordHouse, Nashville, TN. 37232-4700.Email: corey.slovis@mcmail.vanderbilt.edu. Vanderbilt is an equalopportunity employer.

Emergency MedicineRochester, Minnesota

The Department of Emergency Medicine is seeking a full-time aca-demic emergency physician.

The opportunity includes:� practice in a 77,000 visit/year, Level 1 trauma center, with over

17, 000 pediatric visits;� teaching in an emergency medicine residency program, as well

as teaching of off-service residents and medical students;� prehospital/aeromedical program including paramedic base

station, 3 rotor and 1 fixed-wing aircraft and; � research, with administrative support and intramural funding

available;� dynamic faculty with commitment to practice, education and

research.

Candidates must be:� residency-trained emergency medicine specialists;� ABEM board certified or eligible;� individuals with a demonstrated interest in academic emergency

medicine as proven by performance in residency or fellowshiptraining, or faculty positions;

� Minnesota medical licensed or eligible.

Competitive salary with an excellent benefit package and academicappointment through the Mayo Medical School. For further informa-tion, contact:

Wyatt Decker, M.D.Chair, Department of Emergency Medicine

Mayo Clinic1216 Second Street SWRochester, MN 55902Phone (507) 255-6501

Mayo Foundation is an affirmative action and equal opportunity employer and educator.

HEAD OF DEPARTMENT OF EMERGENCY MEDICINE THE UNIVERSITY OF IOWA

University of Iowa Health Care is looking for an academic and clinical leader to heada new Department of Emergency Medicine in the Carver College of Medicine and todirect the Emergency Treatment Center at University of Iowa Hospitals and Clinics. TheUI Carver College of Medicine has made a commitment to develop an academic depart-ment from the existing Program in Emergency Medicine. Witt/Kieffer has been retainedto assist in the recruitment of this departmental executive officer.

The Director and Department Head will be a full-time faculty member at theAssociate or Full Professor rank, and will report to the Collegiate Dean. Board certifi-cation is required either in emergency medicine or in an appropriate discipline withequivalent qualifications based on experience. Previous administrative experience in anemergency medicine program or department is also required. Candidates must be eligi-ble for an Iowa medical license.

The individual will lead the institution in establishing Iowa’s first residency in emer-gency medicine and the first Department of Emergency Medicine. As Department Head,the individual will be responsible for the educational and residency programs; researchprograms; faculty recruitment and development; and clinical programs in emergencymedicine. Excellent research opportunities are present for EM faculty, includingresearch within the clinical operation of the Emergency Treatment Center (ETC), and incollaboration with the Injury Prevention Center and other units of the College of PublicHealth.

As Director of the ETC, the individual will oversee the ETC (faculty, staff and budg-et), helicopter and ground critical care transport services, the paramedic training pro-gram, and will lead departmental participation in state and local EMS activities.

The University of Iowa Health Care comprises the University of Iowa Hospital andClinics and the Roy J. and Lucille A. Carver College of Medicine. The hospital is an873-bed teaching facility and is a nationally recognized teaching hospital. The CarverCollege of Medicine has a budget of $339 million, currently enrolls 680 medical stu-dents, and is ranked 10th in NIH research support among public medical colleges. TheEmergency Treatment Center (ETC) has 29,923 visits annually and is a Level I traumacenter. The hospital has approved a $17 million capital plan to renovate and expand theETC. The successful applicant will be expected to help guide this project.

For additional information, please send a resume in confidence to:

Neill MarshallWitt/Kieffer - Dallas

5420 LBJ Freeway, Suite 460 • Dallas, Texas 75240972-490-1370

or fax resume to 972-490-3472E-mail: neillm@wittkieffer.com

The University of Iowa is an Affirmative Action/Equal opportunity Employer. Women andminorities are strongly encouraged to apply.

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The College of Medicine at the University of FloridaGainesville Campus is recruiting for the position ofClinical Assistant Professor/Clinical Associate Professor inthe Department of Emergency Medicine. This teachinghospital emphasizes active involvement with EmergencyMedicine residents and medical students. The position couldadvance to tenure accruing depending upon qualificationsand level of experience. The ideal applicant will beresidency and board certified in Emergency Medicine,mature with an academic track record, and significantteaching experience. Faculty will provide clinical guidanceand supervision of treatment delivered in the ED. Aprogressive, democratic, superb, 10-person faculty group ofteam players with emphasis on quality emergency care withdedicated customer service. Shands at UF is the hub of amulti-hospital network. Emergency Medicine medicallydirects county EMS and hospital transport including theShandsCare helicopter. Shands Hospital at the University ofFlorida offers a competitive salary and benefits packageincluding relocation incentives. Great compensations, Greatbenefits package, Great City!

Application deadline: September 30, 2002. Anticipated startdate: November 1, 2002. Please send CV to David C.Seaberg, MD, F.A.C.E.P. Associate Professor and AssociateChairman, Department of Emergency Medicine, Universityof Florida, 1600 SW Archer Road, PO Box 100186,Gainesville, FL 32610-0392. Women and minorities areencouraged to apply. University of Florida is an AffirmativeAction Equal Opportunity Employer.

Residency DirectorCook County Hospital

Chicago, IllinoisThe Department of Emergency Medicine at Cook CountyHospital is seeking candidates for Residency Director.Applicants must be residency trained and board certified inEmergency Medicine and active at the national level withresident education and training. Applicants should beenergetic, motivated and possess outstanding teaching andleadership skills. The Department of Emergency Medicine atCook County Hospital has 54 residents in a PGY II-IV formatand 26 full time faculty. The Emergency Departments care for115,000 adult, 30,000 pediatric and 5,000 Level I trauma patientseach year. A new 463 bed Cook County Hospital will becompleted in the fall of 2002 with a new state of the art EDelectronic information system. The Residency Director is incharge of the Education Division within the departmentsupervising all educational activities and provides leadershipand mentoring for the Associate and Assistant ResidencyDirectors. The department offers a very competitive benefitpackage and protected time to pursue educational,administrative and research projects. Faculty appointments areat our medical school affiliate, Rush Medical College.

Interested candidates should contact:Jeff Schaider, MD, FACEP, Associate ChairmanDepartment of Emergency MedicineCook County Hospital1900 West Polk Street 10th floorChicago, IL 60612Telephone - 312 633 5451jschaider@ccbh.org

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/

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University of CincinnatiMedical Center

ANNOUNCING

The University of Cincinnati Department ofEmergency Medicine has established a second

Endowed Chair in Emergency Medicine. We areseeking an established clinician scientist to hold the

EndowedDISTINGUISHED CHAIR FOR CLINICALRESEARCH IN EMERGENCY MEDICINE

The University of Cincinnati Department of Emergency Medicineestablished the first Residency Training Program in EmergencyMedicine in 1970. We have a long history of productive researchwith special emphasis on Cardiovascular, Neurovascular,Toxicology/HBO, and Outcomes investigation. This EndowedChair offers a special opportunity for an individual to pursue aleadership position in Emergency Medicine.Individuals interested in this opportunity are encouraged tocontact:

W. Brian Gibler, MDRichard C. Levy Professor of Emergency MedicineChairman, Department of Emergency MedicineUniversity of Cincinnati College of Medicine231 Albert Sabin WayCincinnati, OH 45267-0769513/558-8086 FAX: 513/558-4599e-mail: Diane.Shoemaker@uc.edu

University of CincinnatiMedical Center

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 andexperience. The University of Cincinnati Departmentof Emergency Medicine established the first residencytraining program in Emergency Medicine in 1970.The Center for Emergency Care evaluates and treats76,000 patients per year and has 40 residents involvedin a four-year curriculum. Our department has a longhistory of academic productivity, with outstandinginstitutional support.

Please send Curriculum Vitae to:

W. Brian Gibler, MDChairman, Department of Emergency MedicineUniversity of Cincinnati Medical Center231 Bethesda AvenueCincinnati, OH 45267-0769

Newsletter AdvertisingThe SAEM Newsletter is mailed every other month to the 5,500members of SAEM. Advertising is limited to fellowship andacademic faculty positions. All ads are posted on the SAEMweb site at no additional charge.

Deadline for receipt: September 1 (Sept/Oct issue), October15 (Nov/Dec issue), February 1 (March/April), April 1(May/June), June 1 (July/August), and August 1(September/October). Ads received after the deadline can oftenbe 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 ....................................................$300

To place an advertisement, e-mail, fax or mail the ad, alongwith contact person for future correspondence, telephone andfax numbers, billing address, ad size, and Newsletter issues inwhich the ad is to appear to: Jennifer Mastrovito at jmastrovito@saem.org, via fax at (517) 485-0801 or mail to 901N. Washington Avenue, Lansing, MI 48906. For more informa-tion or questions, call (517) 485-5484 or jmastrovito@saem.org.

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

Recipients of Visual DiagnosisContest Announced

During the 2002 Annual Meeting in St. Louis a VisualDiagnosis Contest was open to all residents and med-ical students in attendance. The following winners areto be congratulated on their excellent diagnostic skills:

Medical Student Winners: Patrick Stamps-White,University of Iowa.

Resident Winner: Jason Nace, MD, Christiana Care.

The medical student winners will receive a free AnnualMeeting registration to the 2003 Annual Meeting.

The resident winner will receive a textbook and a freeAnnual Meeting registration to the 2003 AnnualMeeting.

SAEM 2003 Research GrantsEmergency Medicine Medical Student Interest Group GrantsThese grants provide funding of $500 each to help support the educational or research activities of emergency medicinemedical student organizations at U.S. medical schools. Established or developing interest groups, clubs, or other medicalstudent organizations are eligible to apply. It is not necessary for the medical school to have an emergency medicine train-ing program for the student group to apply. Deadline: September 4, 2002.

Research Training Grant This grant provides financial support of $75,000 per year for two years of formal, full-time research training for emergencymedicine fellows, resident physicians, or junior faculty. The trainee must have a concentrated, mentored program in spe-cific research methods and concepts, and complete a research project. Deadline: November 1, 2002.

Institutional Research Training GrantThis grant provides financial support of $75,000 per year for two years for an academic emergency medicine program totrain a research fellow. The sponsoring program must demonstrate an excellent research training environment with a qual-ified mentor and specific area of research emphasis. The training for the fellow may include a formal research educationprogram or advanced degree. It is expected that the fellow who is selected by the applying program will dedicate full timeeffort to research, and will complete a research project. The goal of this grant is to help establish a departmental culture inemergency medicine programs that will continue to support advanced research training for emergency medicine residencygraduates. Deadline: November 1, 2002.

Scholarly Sabbatical Grant This grant provides funding of $10,000 per month for a maximum of six months to help emergency medicine faculty at thelevel of assistant professor or higher obtain release time to develop skills that will advance their academic careers. Thegoal of the grant is to increase the number of independent career researchers who may further advance research and edu-cation in emergency medicine. The grant may be used to learn unique research or educational methods or procedureswhich require day-to-day, in-depth training under the direct supervision of a knowledgeable mentor, or to develop a knowl-edge base that can be shared with the faculty member’s department to further research and education. Deadline:November 1, 2002.

Emergency Medical Services Research FellowshipThis grant is sponsored by Medtronic Physio-Control. It provides $60,000 for a one year EMS fellowship for emergencymedicine residency graduates at an SAEM approved fellowship training site. The fellow must have an in-depth trainingexperience in EMS with an emphasis on research concepts and methods. The grant process involves a review and approvalof emergency medicine training sites as well as individual applications from potential fellows. Deadline: November 1,2002.

Neuroscience Research FellowshipThis grant is sponsored by AstraZeneca. It provides one year of funding at $50,000 for an emergency medicine resident,graduate, or junior faculty member to obtain a mentored research training experience in cerebrovascular emergencies. Theresearch training may be in basic science research, clinical research, or a combination of both, and the mentor need notbe an emergency medicine faculty member. Completion of a research project is required, but the emphasis of the fellow-ship is on the acquisition of research skills. Deadline: November 1, 2002.

EMF/SAEM Medical Student Research GrantsThis grant is co-sponsored by the Emergency Medicine Foundation and SAEM. It provides up to $2,400 over 3 months fora medical student to encourage research in emergency medicine. More than one grant is awarded each year. The traineemust have a qualified research mentor and a specific research project proposal. Deadline: February 3, 2003.

Geriatric Emergency Medicine Resident/Fellow GrantThis grant is made possible by the John A. Hartford Foundation and the American Geriatric Society. It provides up to $5,000to support resident/fellow research related to the emergency care of the older person. Investigations may focus on basicscience research, clinical research, preventive medicine, epidemiology, or educational topics. Deadline: March 3, 2003.

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

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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., MD

EditorDavid Cone, MDDavid.Cone@yale.edu

Executive Director/Managing EditorMary Ann Schroppmschropp@saem.org

Advertising CoordinatorJennifer MastrovitoJennifer@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 Didactic Proposals2003 Annual Meeting

May 29-June 1, 2003Boston, Massachusetts

Deadline: September 9, 2002

The Program Committee is soliciting proposals for didactic sessions for the 2003 Annual Meeting. Didacticsessions should emphasize issues of research, education, clinical advances in Emergency Medicine, andfaculty development. Didactics may be aimed at medical students, residents, junior faculty and/or senior faculty.The format may be a lecture, panel discussion, or workshop. The Program Committee will also review proposals forpre- or post-day workshops, or multiple sessions during the Annual Meeting aimed at in-depth instruction in aspecific discipline. Didactic proposals should support the mission of SAEM and should fall into one of the followingcategories:

• Education (education methodology, improving the quality of education, enhancing teaching skills)• Research (research methodology, improving the quality of research)• Career Development • State-of-the-Art (presentation of cutting-edge basic science or clinical research that has important implications

for further investigation or the future practice of emergency medicine)• Health Care Policy and National Affairs

Note that State-of-the-Art sessions are not a review of the literature of a summary of clinical practice. All submittersare asked to briefly explain how the session meets the SAEM mission.

The deadline for submission is Monday, September 9, 2002 at 5:00 pm Eastern Time. Only on-line submissionswill be accepted. To submit a proposal, complete the on-line Didactic Submission Form at www.saem.org. Foradditional questions or information, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

SAEM