NEWSLETTERNewsletter of the Society for Academic Emergency Medicine November/December 2001 Volume XIII, Number 6

PRESIDENT’S MESSAGE

Half Time AssessmentWe are mid way through my term as

SAEM president and in this message Iprovide you a halftime assessment ofthe progress in achieving objectives out-lined earlier during the year. Before pro-viding that assessment, I express con-cern and support of the many families,friends, and EMS personnel affected bythe tragedies of September 11, 2001and the ongoing acts of bio-terrorism.This has been a trying past few months

for Americans as we have experienced terrible acts upon citizensof our country. Our sense of security has been disrupted like notime before. Like many of you, I have developed a renewed senseof purpose in life and a deeper appreciation of my family, countryand fellow Americans. It is painful to recall the events ofSeptember 11, 2001. On that day I was in the midst of my emer-gency department’s newly formed Emergency Medicine Center forEducation, Research and Technology (EMCERT) Advisory Boardmeeting. This board, comprised of mostly community citizens(non-clinicians), was in shock as we viewed the live footage of thedevastating loss of lives and the collapse of monumental struc-tures before our eyes. Our meeting ended with sadness, bewil-derment and helplessness. After making sure my department waspoised to help potential victims of the Pentagon attack (we arelocated within two hours of Washington, DC), I then held theprescheduled SAEM Board teleconference that day. The Board’sresolve was to help in any way we could, beginning with a mes-sage to support our fellow EMS providers in New York, DC andPennsylvania. The message we sent was as follows: "The SAEMBoard of Directors held its conference call today and among theissues discussed was the tragedy of today’s events that shockedthe world. We express deep concern for the victims and their fam-ilies and offer our emotional support to all the healthcare workersso diligently working on the front lines to provide care."

During the ensuing 24 hours, we received responses from ourmembership. The following are a select few:

"Dear colleagues: Thanks so much for your thoughts and con-cerns for all of us involved in this horrible tragedy. At times likethese it helps to receive support from our friends. The lethality ofthe event was incredible with most victims dead at the scene, weare trying to go back to business as usual today but nothing willever be the same. Thank you for your thoughts." Shelly Jacobson

"From all the way on the other side of the world in Singapore,we watched in horror the unfolding of the terrible tragedy that isoccurring in New York, Washington DC, and Pennsylvania. Our

Marcus Martin, MD

Something New: Innovations in Emergency

Medicine Education ExhibitsEllen Weber, MDChair, SAEM Annual Meeting Program CommitteeUniversity of California, San Francisco

We’d like to call your attention to an important changein the submission process for Innovations in EmergencyMedicine Education (IEME) Exhibits. In the past, thoseinterested in describing or displaying such innovationssubmitted the concept as a scientific abstract, following thestructured abstract format for all scientific papers. Thisworked well for those who had conducted scientificresearch or assessments on their inventions, but made itdifficult for those who wished to display an innovative idea.In addition, the Program Committee found these submis-sions inconsistent with the rest of the scientific abstractsand could not fairly judge them on the same criteria.

Therefore, we have created a separate submissionprocess for the IEME exhibits. You will be asked to submitan application (not an abstract) describing an innovativenew educational methodology or an innovative education-al application of an existing product. The exhibit should notbe used to display a commercial product that is alreadyavailable and being used in its intended application.Exhibits will be selected based on utility, originality, andapplicability to the teaching setting. Commercial support isallowed, but must be disclosed on the application and atthe exhibit.

Applications will be due on February 15, and will bejudged by a review committee consisting of SAEM mem-bers who are knowledgeable in education and technology.Decisions will be made on March 15. Exhibitors will beresponsible for the costs of audiovisual or other equipmentrental and computer internet connections.

If you have completed a well-designed scientific studyevaluating a new educational methodology, we encourageyou to submit a traditional scientific abstract for presenta-tion. These are due on January 8, 2002. If you do submita scientific abstract you will note that we have eliminatedthe IEME abstract category; instead you should now selectthe most appropriate subject category for the innovation(e.g. education, computer modeling, research methodolo-gy, cardiology, etc.)

I would like to thank Cathy Custalow, MD, and her sub-committee for putting together this new approach to theIEME Exhibits.

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SAEM NEWSLETTER

901 North

Washington Ave.

Lansing, MI

48906-5137

(517) 485-5484

saem@saem.org

www.saem.org

2

Call for SubmissionsInnovations in Emergency Medicine Education Exhibits

2002 Annual MeetingDeadline: February 15, 2002

The Program Committee is accepting applications for review for the Innovations in Emergency Medicine Education(IEME) Exhibits at the 2002 SAEM Annual Meeting, May 19-22 in St. Louis. Submitters are invited to complete an applica-tion describing an innovative new educational methodology that they have designed, or an innovative educational applica-tion of an existing product. The exhibit should not be used to display a commercial product that is already available and beingused in its intended application. Exhibits will be selected based on utility, originality, and applicability to the teaching setting.Commercial support of innovations is permitted but must be disclosed. IEME exhibits will not be published in AcademicEmergency Medicine with other abstracts, but will be listed in the on-site program. However, if submitters have conducteda research project on or using the innovation, the project may be written up as a scientific abstract and submitted for scien-tific review in the appropriate subject category by the January 8 deadline.

The deadline for submission of IEME Exhibit applications is Tuesday, February 15, 2002 at 5:00 pm Eastern Time andwill be strictly enforced. Only electronic submission via email attachment to saem@saem.org will be accepted. The appli-cation form and instructions will be available on the SAEM web site at www.saem.org in November. For further informationor questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Society for Academic Emergency Medicine • 901 North Washington Avenue • Lansing, MI 48906

SAEM

Academic Emergency Medicine WebsiteBrian O’Neil, MDEditorial Board, Academic Emergency MedicineDetroit Receiving Hospital

I certainly do not view myself as atechnocrat nor a computer jockey; how-ever, I do enjoy things that help simplifymy life and make me more efficient.One of those things would be theAcademic Emergency Medicine websitefound at www.aemj.org. This web site isfree to all AEM subscribers and is main-tained by Stanford Universities LibrariesHighwire Press ™. Although this website can make each of us significantlymore efficient, it has been accessed byonly a small percentage of the AEMsubscribers. I am confident that the rea-son some of you have not accessed oursite is that you have not been fullyacquainted with the features of AEM on-line.

Computer neophytes need not beapprehensive when accessing theAEMJ homepage as the setup of site isabsolutely unpretentious, extremelyuser-friendly, and seamless. The home-page is simple, uncluttered, andergonomically split into the areas uti-lized the most. A small headline bannerproclaims upcoming events and dead-lines. Below this, a small area displaysthe headings View Future Titles, Selectan Issue from the Archive, Search for

Articles and Collected Papers, as wellas a picture of our current issue. On theleft side, a quick reference bannerallows access to information includingthe make-up of the editorial board, emailalerts, positions available, help, tips, andfeedback.

After the initial registration (verypainless), the system stores a “cookie”that recognizes the subscriber uponreturn to the site, saving login time.Many websites will let you search theirdatabase to the point where you canread the abstract, but when you wish toobtain the full text of the article, theyrequire an ID, password, or money. Toobtain the full text of an AEM articlehowever, requires only a mouse click onthe full text prompt.

One can search either archives ofold issues or all available issues by cita-tion, author, or keywords. Each of thesubscreens allows you to quickly moveback to either the home page or helppage, provide feedback, obtain sub-scriptions, access the archives, orrepeat the search, simply by clicking onone of the blue boxes on the header.When searching the archives, the fulltext and abstracts are available back toJanuary of 1999. The ability to pull upfull text articles from the computer is agodsend to anyone who has spent timesearching through old bound journals inthe library catacombs, camped out in

front of copy machine sucking toner, orfed all their money to the copy cardbeast. Even if you subscribe to thepaper journal, the on-line version savesyou the time and aggravation of havingto search through the pile of journalsyour kids have stacked into a fort tokeep the dragons out. Being near to theold guard, I still prefer to read my arti-cles on paper, and the PDF formatallows me to quickly print out a high res-olution article from the comfort of myoffice or home.

When you access an abstract, anoptions box at the top right allows you toget the full text of this article, reprint thePDF version of this article, or searchsimilar articles through PubMed. Whenyou click on the PubMed option, you aretaken directly to The National Library ofMedicine search page and it automati-cally searches for similar articles in itsdatabase. The speed of the transfer isactually quite good, even on my homecomputer with a 28K modem, with trans-fer and downloads times of less thanone minute.

The web site can also make youmore efficient by allowing you to down-load directly to your citation manager, inthe EndNote, Reference Manager,ProCite, and Medlars formats. You alsohave the option, if your citation manageris not listed, to request that an addition-al format be added to this list. Another

(continued on page 23)

SAEM Membership Dues IncreasedDonald M. Yealy, MDSAEM Secretary/TreasurerMarcus Martin, MD SAEM President on behalf of the Board of Directors

The major task of the SAEM Boardof Directors is to lead the organizationand fulfill its mission and goals. Towardthat, the Board must manage theSociety’s resources. At the most recentmeeting on October 14, 2001, the Boardvoted to increase the dues for renewaland new applications for membership inthe Society for calendar year 2002. Thenew yearly dues are $365 for activemembers and $350 for associate mem-bers. This increase is the first since1995, representing an annualizedincrease of approximately 3%. We willnot raise dues for the residents or stu-dents, the future of our organization. Itis essential to share the thoughts behindthis important decision with the SAEMmembers.

For the fiscal year ending December31, 2001, the Society will have a smallnet positive balance on operations(income received minus expenses).However, to fulfill the planned activitiesfor the next year and beyond, an operat-ing deficit would be realized without anincrease in revenues. The Boardweighed all options: reducing or elimi-nating programs and expenses; usingreserves; or increasing revenues.Currently, revenue comes mostly frommembership dues, Annual Meeting reg-istration fees, and investment income.Given recent market conditions, theBoard could not depend on enhancedrevenue from investments. After carefuldeliberation, we chose to increase themembership dues while continuingefforts to operate more efficiently.

Our Society offers value to its mem-bers; our goal is to continue to provideand increase that value. For sevenyears, the Society has improved themember benefits while maintaining thesame membership fee. These new orimproved member benefits include:

� Ongoing and increased leadershipin academic emergency medicineissues, with representation at theAAMC, AHRQ, NIH, NHLBI, and manyother organizations;

� A strong voice in the communitiesof emergency medicine and medicine,working collaboratively with ACEP,ABEM, CORD, EMRA, AAEM, AACEM,AMA and other organizations;

� Development, alone or collabora-tively, of position papers and commen-tary pieces that influence health care,from the training of providers throughdelivery of care to legislative advocacy;

� Growth of Academic EmergencyMedicine, our Society’s well respectedjournal, now cited in Index Medicus, gar-nering a high impact factor within ourfield, and with electronic accessibility;

� Continuation of the premiereAnnual Meeting for those interested inacademic emergency medicine, whichhas grown in size, content, and diversi-ty;

� Creation of focused conferencesand published symposia on "Errors inEmergency Medicine" and "EDOvercrowding and The UnravelingSafety Net" – both current issues facingacademic emergency physicians andthe broader health care community

� The development and support forRegional Meetings to augment researchand educational opportunities for allmembers, including trainees, junior fac-ulty, and those who might not be able toattend the Annual Meeting;

� Expanded opportunities for Societyinvolvement by members, includinginterest groups, task forces, andenhanced committee structures;

� The creation of research fundingopportunities (alone or in collaboration)for members to develop the skills andknowledge to compete for governmentalsupport. These include newer grants -the Scholarly Sabbatical, ResearchTraining, Institutional Training, andNeurosciences Research Fellowship -to complement the pre-existing EMSResearch Fellowship, Geriatric Awards,Innovations in Medical Education andMedical Student Awards (the latter twowith the Emergency MedicineFoundation);

� A timely communication baseusing both traditional ‘hard copy’ - thisNewsletter - and a growing electronicforum based on the SAEM Web page.The Web page is a valuable tool, grow-ing yearly in content and flexibility. It isthe tool for abstract submission andmeeting registration, easing this task formembers.

� Development and distribution ofnew career materials and services invaried formats - the Academic CareerGuide (2000) for junior faculty, theVirtual Advisor Program (2001) for med-ical students and the FacultyDevelopment Website (2001) for junior

to mid-career faculty.� Expansion of programs for the

increased number of medical studentand resident members, including dedi-cated educational materials at theAnnual Meeting, separate sections onthe Web page, involvement in the SAEMcommittees, and a Resident Boardmember on the Board of Directors.

� Creation of the Research andEthics Consulting Services, to augmentthe Residency Consulting Service. Eachof these offers skilled insight for pro-grams or academicians in need.

In planning for the future, we believea dues increase is both necessary andthe responsible thing to do for theorganization. The people of SAEM arethe most important resource – the mem-bers who donate their time, expertise,enthusiasm and support, together with atalented, hard-working professionalstaff. We need all of our resources –human and financial – to improve thereturn for every member. We value eachSAEM member, and we look forward toyour support and feedback.

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Geriatric EmergencyMedicine

Resident/FellowGrants Available

SAEM, with sponsorship fromthe John A. Hartford Foundationand the American Geriatric Society,is pleased to announce the avail-ability of grants to support resi-dent/fellow research related to theemergency care of the older per-son. Investigations may focus onbasic science research, clinicalresearch, preventive medicine, epi-demiology, or educational topics.Awards may be up to $2,500 foreach project.

Applications for the GeriatricEmergency Medicine Resident/Fellow Grant may be obtained fromthe SAEM office or the website atsaem.org. The deadline for receiptof a complete application at theSAEM office is March 4, 2002 withnotification of selections by May 7and funding awarded by July 1.

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2002-2003 SAEM Committee/Task Force Interest Form Deadline: February 1, 2002

Members interested in serving on an SAEM committee or task force in 2002-2003 should submit this form,along with a current curriculum vitae and a cover letter describing relevant experience or other qualifications,

and likely contribution to the committee or task force. Completed forms submitted as e-mail attachments to saem@saem.orgare preferred, however mail and fax copies are also acceptable. Members are encouraged to review the following materi-als, available on the home page at www.saem.org or upon request from the SAEM office:

1. Committee/task force orientation guidelines that detail the role and structure of SAEM's committees and task forces.2. Current 2001-2002 committee/task force objectives.3. SAEM mission and vision statement, and SAEM's five-year goals and objectives.4. The article in the November/December Newsletter by Dr. Lewis, the current SAEM President-elect, regarding the com-

mittee/task force member selection process.

The following guidelines should be noted:1. The completed interest form, CV, and letter must be received by February 1, 2002.2. SAEM members, even if currently serving on a committee or task force, must submit a complete application to be con-

sidered for appointment or reappointment.3. Due to the relatively small number of committees and task forces, preference will be given to those whose applications

are thoughtful and focused.4. Committee and task force appointments and reappointments will be made by the President-elect by April 15, 2002. The

term of appointment is May 2002 to May 2003.5. Committee and task force members are expected to attend all meetings and actively participate in the committee/task

force activities. All committees and task forces meet at the SAEM Annual Meeting and many meet at the ACEP ScientificAssembly.

6. Individuals must be SAEM members to serve on a committee or task force.7. In general, one resident will be appointed to each committee and task force.

1. Which description best characterizes you?❒ EM resident, will complete residency in 20____.❒ Faculty member without previous SAEM committee or task force experience.❒ Faculty member with previous SAEM committee or task force experience.❒ Other (e.g. fellow):_________________

2. Is there a particular committee or task force in which you are interested? ❒ Yes ❒ NoIf so, which one(s): ______________________________________________________________________________

3. Is there a particular objective on which you are interested in working? ❒ Yes ❒ NoIf so, which one(s): ______________________________________________________________________________

4. What specific objectives or tasks do you think SAEM should pursue in the coming year?

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

5. Have you previously served on an SAEM committee or task force? ❒ Yes ❒ NoIf yes, list name of committee/task force and time period served:

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Name: ____________________________________________________________________________________________

Institution: ________________________________________________________________________________________

E-mail address: ____________________________________________________________________________________

Fax number: ______________________________________________________________________________________

Return to SAEM at 901 N. Washington Ave., Lansing, MI 48906, fax (517) 485-0801, or e-mail at saem@saem.org

SAEM

5

Choosing Members for 2002-2003 Committees and Task Forces: The Selection Process and How to Apply

Roger J. Lewis, MD, PhDSAEM President-electHarbor-UCLA Medical Center

In this issue of the SAEM Newsletter,a Committee Interest Form is included,so that all SAEM members may applyfor positions on SAEM committees.SAEM Committees are the "engine"which drives the organization. It isthrough the work of these committeesthat the mission of SAEM is advanced,the quality of our Annual Meeting main-tained and improved, and in which manyof the new ideas which strengthen ourorganization are developed and nur-tured.

Being appointed to an SAEM com-mittee is both an opportunity and a com-mitment. It is an opportunity to work toimprove the world of academic emer-gency medicine and to influence thedirection of the Society as a whole.Because there are frequently moremembers who wish to serve on SAEMcommittees than available committeepositions, it is expected that each mem-ber applying for a position is prepared tomake a significant commitment towardscompleting the work of the committee.One should only apply to become amember of an SAEM committee if youare willing and able to commit substan-tial time and energy.

It is important that potential commit-tee members be aware that the goalsand objectives of each committee arenot set by the committees themselves,but are guided by the five-year goalsand objectives of the Society anddefined by the Board of Directors. Thus,committee members must be prepared

to put their efforts towards the comple-tion of predefined goals and objectives.As outlined below, however, there is sig-nificant opportunity to influence thegoals and objectives of the committeesthrough feedback to each committeechair or to the Board of Directors direct-ly. The SAEM Board of Directors setsthe Goals and Objectives for each com-mittee and task force to help ensure acoordinated set of activities and toreduce duplicative efforts.

How are new Committee membersselected? First, each committee chair isasked to evaluate the performance ofeach current committee member.Committee members are evaluated interms of their productivity, work effort,responsiveness to requests, and overallcontribution to the function of the com-mittee. Approximately one-third of eachcommittee’s membership is rotated offeach year, based on both the chair’sevaluation of each member’s perform-ance, and based on the number of yearseach member has served on the com-mittee. This rotation is extremely impor-tant to ensure that as many SAEMmembers as possible have an opportu-nity to participate in the Society’s efforts.

All prospective committee members,whether currently on an SAEM commit-tee or with no prior experience, arerequired to submit a Committee InterestForm in order to be considered for newappointment or reappointment. TheCommittee Interest Form should beaccompanied both by a current curricu-lum vitae, as well as a narrative state-ment outlining the applicant’s motiva-tions for joining the committee, ideas

regarding areas in which they may con-tribute to the committee, and any otherinformation the applicant deems rele-vant. In evaluating these applications,the President-elect looks for evidence ofenthusiasm, focus, realism, new ideas,and commitment. Applications are gen-erally much stronger if they demonstratean understanding of SAEM’s mission,the five-year plan for the organization,and the current year’s goals and objec-tives for the individual committee (thisinformation can be found at the SAEMwebsite at www.saem.org). Please beaware that one-half or more of the goalsand objectives for each committee arerepeated each year. For example, onecan anticipate that an objective for theProgram Committee will always be tocoordinate the Annual Meeting, to selectabstracts for oral and poster presenta-tion, and to select didactic presenta-tions.

Among some SAEM members thereis an unfortunate perception that beingappointed to an SAEM committeerequires being a member of some innercircle. On the contrary, each year thePresident-elect makes a concertedeffort to appoint members who have notpreviously had an opportunity to serve,as part of an ongoing effort to developnew leadership talent in the Society.Because the President-elect cannotknow all members equally well, theinformation provided in the narrativestatement and curriculum vitae isweighted heavily in the selectionprocess. This helps to ensure fairness,opportunity, and a well-balanced com-mittee and task force membership.

The Editors of Academic EmergencyMedicine announce the next AEMConsensus Conference on “AssuringQuality” to be held on May 18 in St.Louis. The conference will aim todescribe means of defining, assessing,measuring, and researching the deliveryof quality emergency care in the clinicalsetting. We believe the conference is alogical progression in our consensusseries, which has included “Errors inEmergency Medicine,” and “The

Unraveling Safety Net.” We thereforeissue this call for papers related to thetopic of Assuring Quality. Submittedmanuscripts are due on March 1, 2002.Accepted papers will be published in thelate fall of 2002, along with Proceedingsfrom the consensus conference.

Please submit eligible papers to theAEM editorial office in Lansing ataem@saem.org. Electronic submissionof the original and a blinded copy arepreferred. Submit also a cover letter

clearly indicating that your submission isfor the Assuring Quality ConsensusConference. General instructions forauthors appear at www.saem.org/inform/journal.htm.

Any questions regarding this call forpapers on the AEM ConsensusConference can be directed to MichelleBiros, MD, at biros001@maroon.tc.umn.edu or Jim Adams, MD, at:jadams@nmh.org.

AEM Call for Papers“Assuring Quality”

6

Call for NominationsSAEM Elected Positions

Deadline: February 1, 2002

Nominations are sought for the SAEM elections which will be held in the spring of 2002 via mail or electronic bal-lot. The Nominating Committee will select a slate of nominees based on the following criteria: previous service to

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

Interested members are encouraged to review the appropriate SAEM orientation guidelines (Board, Committee/Task Force orPresident-elect) to consider the responsibilities and expectations of an SAEM elected position. Orientation guidelines are availableat www.saem.org or from the SAEM office.

The Nominating Committee wishes to consider as many candidates as possible and whenever possible will select more than onenominee for each position. Nominations may be submitted by the candidate or any SAEM member and should include the candi-date's CV and a cover letter describing the candidate's qualifications and previous SAEM activities. Nominations are sought for thefollowing positions:

President-elect: The President-elect serves one year as President-elect, one year as President, and one year as Past President.Candidates are usually members of the Board of Directors.Secretary/Treasurer: The Secretary/Treasurer serves a three-year term on the Board. Candidates should have a track record ofexcellent service and leadership on SAEM committees and task forces and are usually members of the Board.Board of Directors: Two members will be elected to three-year terms on the Board. Candidates should have a track record ofexcellent service and leadership on SAEM committees and task forces.Resident Board Member: The resident member is elected to a one-year term and is a full voting member of the Board. Candidatesmust be a resident during the entire term on the Board (May 2002-May 2003) and should demonstrate evidence of strong interestand commitment to academic emergency medicine. Nominations should include a letter of support from the candidate's residencydirector.Nominating Committee: One member will be elected to a two-year term. The Nominating Committee selects the recipients of theSAEM awards (Young Investigator, Academic Excellence, and Leadership) and develops the slate of nominees for the elected posi-tions. Candidates should have considerable experience and leadership on SAEM committees and task forces.Constitution and Bylaws Committee: One member will be elected to a three-year term, the final year as the chair of theCommittee. The Committee reviews the Constitution and Bylaws and makes recommendations to the Board for amendments to beconsidered by the membership. Candidates should have considerable experience and leadership on SAEM committees and taskforces.

SAEM

Two New Residency ProgramsApproved

During the September meeting of the ResidencyReview Committee for Emergency Medicine two newemergency medicine residency programs wereapproved:

University of Alabama The University of Alabama at Birmingham program

is a 2,3,4 program and was approved six residents peryear. The residency director is James M. Leaming, MD,and the chair of the department is Thomas E. Terndrup.The program includes the University of AlabamaHospital and Children’s Hospital of Alabama with acombined total of over 90,000 patient visits per year.

Maimonides Medical CenterThe residency program at Maimonides Medical

Center in Brooklyn, New York has been approved for 9residents per year and is a 1,2,3 program. AmyChurch, MD, is the residency director and Steven J.Davidson, MD, is the chair of the department. The insti-tution sees over 70,000 patient visits per year.

SAEM would like to congratulate the faculty and res-idents at these two new programs. There are now 124approved emergency medicine residency programs inthe U.S. Complete details on these programs can befound in the SAEM Residency Catalog atwww.saem.org.

The 2001 Final CPC Competition was held October 15 during the ACEP Scientific Assembly. Mary Ryan, MD,

from Lincoln Medical and Mental Health was selected as theBest Discussant and Michael Gisondi, MD, from

Stanford-Kaiser was selected as the Best Presenter.The 2002 Semi-Final Competition will be held on May 18 in St. Louis, the day before the SAEM Annual Meeting.

Academic AnnouncementsMichael Callaham, MD, has assumedthe role of Editor of Annals ofEmergency Medicine. Dr. Callaham isthe Chief of the Division of EmergencyMedicine at the Medical Center at theUniversity of California, San Franciscoand has served as Professor of ClinicalMedicine since 1990. He has served aschair of the Ethics Committee of theWorld Association of Medical Editorsand chair of the Editorial PolicyCommittee for the Council of ScienceEditors.

Sharon K. Griswold, MD, has beenappointed the residency director of theemergency medicine residency pro-gram at Thomas Jefferson University.She formerly served as assistant resi-dency director.

Gwen Hoffman, MD, has assumed thepresidency of the American Board ofEmergency Medicine. She completedan EM residency at ButterworthHospital in Grand Rapids, MI, and

served as residency director for 21years. She is chair of the EmergencyMedicine Department and president-elect of the Medical Staff at SpectrumHealth-Blodgett and Butterworth cam-puses in Grand Rapids.

During the ACEP Scientific Assembly inChicago, Judd Hollander, MD, was pre-sented with the ACEP OutstandingContribution in Research Award. Dr.Hollander is Professor of EmergencyMedicine at the University ofPennsylvania.

Bernard L. Lopez, MD, has beenappointed Assistant Dean for StudentAffairs at Jefferson Medical College atThomas Jefferson University. Dr. Lopezalso serves as the Director of ClinicalResearch in the Division of EmergencyMedicine.

Donald Yealy, MD, was presented theOutstanding Contribution in EducationAward during the recent ACEP Scientific

Assembly in Chicago. Dr. Yealy isProfessor of Emergency Medicine at theUniversity of Pittsburgh.

Blaine C. White, MD, has recently beenappointed to the Institute of Medicine ofthe National Academy of Sciences. Dr.White is Professor of EmergencyMedicine at Wayne State University.

Robert J. Zalenski, MD, MA, has beenawarded a Certificate of Recognitionfrom the National Heart Attack AlertProgram for nearly a decade of service.Dr. Zalenski served as the SAEM repre-sentative to the NHAAP CoordinatingCommittee from 1992-2001 and servedin a variety of other roles.

SAEM members are encouraged tosubmit Academic Announcements onpromotions, research funding, and otheritems of interest to the SAEM member-ship for publication in the Newsletter.Submissions should be sent tosaem@saem.org

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Call for NominationsDeadline: February 1, 2002

Nominations are sought for the Hal Jayne Academic Excellence Award and the Leadership Award. These awardswill be presented during the SAEM Annual Business Meeting in St. Louis. Nominations for honorary membership

for those who have made exceptional contributions to emergency medicine are also sought. The Nominating Committeewishes to consider as many exceptional candidates as possible. Nominations may be submitted by the candidate or anySAEM member. Nominations should include a copy of the candidate’s CV and a cover letter describing his/her qualifications.Nominations can be sent to saem@saem.org or 901 N. Washington Ave., Lansing, MI 48906. The awards and criteria aredescribed below:

SAEM • 901 N. Washington Ave., Lansing, MI 48906 • www.saem.org

SAEM

Academic Excellence AwardThe Hal Jayne Academic Excellence Award is presented toa member of SAEM who has made outstanding contribu-tions to emergency medicine through research, education,and scholarly accomplishments. Candidates will be evaluat-ed on their accomplishments in emergency medicine,including:1. Teaching

A. Didactic/BedsideB. Development of new techniques of instruction or

instructional materialsC. Scholarly worksD. PresentationsE. Recognition or awards by students, residents, or peers

2. Research and Scholarly AccomplishmentsA. Original research in peer-reviewed journals

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

C. Research support generated through grants and con-tracts

D. Peer-reviewed research presentationsE. Honors and awards

Leadership AwardThe Leadership Award is presented to a member of SAEMwho has demonstrated exceptional leadership in academicemergency medicine. Candidates will be evaluated on theirleadership contributions including:1. Emergency medicine organizations and publications.2. Emergency medicine academic productivity.3. Growth of academic emergency medicine.

2001 Healthy People ConsortiumMeeting

Carlos Camargo, MD, DrPHChair, SAEM Public Health Task ForceMassachusetts General Hospital

The Healthy People Consortium Meeting, Creating Changewith Healthy People 2010, was held October 19, 2001 in Atlanta.The Healthy People Consortium is an alliance of more than 600organizations (including SAEM) that are committed to makingAmericans healthier by supporting the goals and objectives ofHealthy People 2010.

At the Consortium Meeting, approximately 400 people heardspeakers discuss the greatest potential and the greatest chal-lenge facing Healthy People 2010: How do we translate thisnational vision into local action … action that will make a real dif-ference in the lives of the people of this Nation? The PlenarySession speakers provided specific examples of "Action in theField" from a variety of perspectives: international, business, pro-fessional organization, region, and state. Conference attendeesthen participated in three breakout sessions, facilitated by nation-al leaders, with work groups addressing all 28 Focus Areas ofHealthy People 2010.

If SAEM members are interested in learning more aboutHealthy People 2010, I encourage you to browse:http://www.health.gov/healthypeople/. For news updates andannouncements, you may want to join the Healthy PeopleListserve at: http://list.nih.gov/archives/healthypeople.html. Lastly,if you would like to help the SAEM Public Health Task Force withED-based implementation of Healthy People 2010, please contactme at ccamargo@partners.org. We would welcome your assis-tance with several ongoing projects, and would gladly help you toimplement your own ED-based programs/studies that support thegoals of Healthy People 2010. CORD Best Practices Conference

CORD is sponsoring a consensus conference, to be heldon March 2-4, 2002 in Washington, DC, to present and dis-cuss "best practice" models in emergency medicine residen-cy education. The conference will highlight models to incor-porate the six new ACGME core competencies into educa-tional programs and will also explore "best practices" in otherimportant areas of the emergency medicine residency cur-riculum. We will focus particularly on topics related to resi-dent evaluation and assessment. The conference willinclude general discussion sessions as well as small groupbreakout sessions. We have invited educational leaders fromthe ACGME and other academic organizations to participatewith us. We also plan to publish the results of the conferencework in a special issue of Academic Emergency Medicine.

CORD is excited about the potential for emergency med-icine, with this consensus conference, to provide a leader-ship role among the specialties in medicine in developingeffective educational models for resident competency. Thesuccess of this conference, however, depends largely on thecontributions of those in the academic emergency medicinecommunity.

To that end, we invite members of CORD and SAEM toparticipate in this conference and to share your experienceand ideas about these important and timely issues. Pleaseset aside these dates in your calendar to attend this impor-tant conference.

For more information contact CORD at cord@cordem.org

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Faculty Development Conference:Navigating the Academic Waters

March 2-4, 2002 – Washington, DCFaculty development continues to be one of the most careful-

ly scrutinized areas by the RRC-EM. Due to the relative growthof our specialty, coupled with rapid growth of residency programsover the past 10 years, many younger faculty struggle to developneeded personal, management, teaching, and research skillsrequired for successful career advancement. CORD andAACEM have conjointly developed a seminar entitled: “Navigatingthe Academic Waters: Tools for Emergency medicine”. This con-ference was first held in November 1996 and received high praisefrom attendees. The conference is designed specifically for theunique needs of junior Emergency Medicine faculty and willaddress essential elements necessary for success in an aca-demic environment including research development, grants, pre-sentations skills, resident evaluation, mentoring and clinicalteaching, as well as time and personal management. This coursenicely augments the ongoing efforts made by SAEM in the areaof faculty development. Young faculty or senior residents interested in an academic career should contact theCORD/AACEM office at 517-485-5484 or the CORD web site at www.cordem.org. Registration is limited to 125 people, so call today!

Nominations Requested forResident Member of the SAEM

Board of DirectorsNominations are sought for the resident member of

the SAEM Board of Directors.The resident Board mem-ber is elected to a one-year term and is a full votingmember of the Board. The deadline for nominations isFebruary 1, 2002.

Candidates must be a resident during the entire oneyear term on the Board (May 2002-May 2003) and be amember of SAEM. Candidates should demonstrate evi-dence of strong interest and commitment to academicemergency medicine. Nominations should include a let-ter of support from the candidate’s residency director,as well as the candidate’s CV and a cover letter.Nominations should be sent to saem@saem.org or 901N. Washington Ave., Lansing, MI 48906. Candidatesare encouraged to review the Board of Directors orien-tation guidelines on the SAEM web site atwww.saem.org or from the SAEM office.

The election will be held via mail ballot in the Springof 2002 and the results will be announced during theAnnual Business Meeting in St. Louis.

The resident member of the Board will attend fourSAEM Board meetings; in the fall, in the winter, and inthe spring (at the 2002 and 2003 SAEM AnnualMeetings). The resident member will also participate inmonthly Board conference calls.

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Call for NominationsYoung Investigator Award

Deadline: December 15, 2001

Again this May, SAEM will recognize a few young investigators who have demonstrated promise and distinction in theiremergency medicine research careers. The purpose of the award is to recognize and encourage emergency physicians/sci-entists of junior academic rank who have a demonstrated commitment to research as evidenced by academic achievementand qualifications. The criteria for the award includes:

1. Specialty training and certification in emergency medicine or pediatric emergency medicine.

2. Evidence of significant research collaboration with a senior clinical investigator/scientist. This may be in the setting of acollaborative 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 15, 2001. Nominations should include the candidate’s CVand a cover letter summarizing why the candidate merits consideration for this award. Candidates can nominate themselvesor any SAEM member can nominate a deserving young investigator. Candidates may not be senior faculty (associate or fullprofessor) nor be more than seven years beyond residency training at the time of application.

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

Send submissions to SAEM at saem@saem.org or 901 N. Washington Ave., Lansing, MI 48906

SAEM

Scholarly Sabbatical Grant Recipient ReportsScott Tadler, MDMedical College of Virginia

As the recipient of the 2000-2001SAEM Scholarly Sabbatical Award, I amwriting to describe my experience. Togive a bit of background, I graduatedresidency in 1997 from the University ofPittsburgh. While there, I became affili-ated with Clifton Callaway, MD, PhD,and James Menegazzi, PhD. This rela-tionship helped to kindle what was, atthat time, a largely unexplored interestin research. I was fortunate enough tobefriend Clif and his family and we spentmany an evening brainstorming interest-ing ideas about cerebral resuscitationand the like. Some preliminary workwith external cooling of swine duringresuscitation from cardiac arrest waspresented at a national meeting of theNational Association for EMSPhysicians (NAEMSP) where I won anaward. I was also presented an awardfrom the residency for my research.

Shortly after, I left for a faculty posi-tion at the new Department ofEmergency Medicine at the VirginiaCommonwealth University (where I am

currently practicing). Upon arrival,awareness of my own lack of expertiseand independence was intensified. Ispent a lot of time "spinning my wheels,"so to speak. Upon the arrival of KevinWard, MD, a new mentoring relationshipwas established and I began to developconstructive research relationships andplans. In collaboration with Dr. Wardand Anthony Marmarou, PhD, I becamethe Department’s representative for thestudy of the use of Xenon CT for acuteischemic stroke and was introduced tothe Marmarou laboratory.

It is my opinion that an inability toperform animal and basic scienceresearch limits one’s ability to explorefully any area of investigation. As aresult it was my goal to become moreproficient with laboratory techniquesand more independent in developingworkable hypotheses. Nevertheless, Iwas working in a very busy ED that, likemany others, falls under tremendousfinancial pressures. It was difficult tofind time to hone techniques and refinea specific hypothesis and research plan.Fortunately, I was made aware of theSAEM scholarly sabbatical grant and

made a successful application.As a result my clinical commitment

was greatly reduced from June untilDecember 2000. An ambiguous andpoorly thought out research plan wasrevised and formalized and limited ani-mal skills have broadened greatly. Withfurther salary support in January andFebruary, I submitted an application tothe NIH, National Institute on Aging forthe Mentored Clinical ScientistDevelopment Award (K-08). For variousreasons, I was unsuccessful with thisattempt. My preliminary data was limit-ed and my publication record not quitewhat was desired. Nevertheless, as aresult of the SAEM grant I was able to,in large part independently, prepare andsubmit an application for research sup-port that involved an important researchquestion. With mentorship and guid-ance, I formulated an important hypoth-esis, collected and analyzed data andsubmitted the grant. For me, this repre-sented both an important accomplish-ment and great experience.

My goal in writing this article is tobring an awareness to a large number ofjunior faculty the availability of a won-

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Recollections of September 11Sheldon Jacobson, MDMt. Sinai Medical Center

In the last 3 weeks we all have had to come to grips withthe reality of the World Trade Center and Pentagon tragedies.Needless to say, we have had to shift our priorities, both pro-fessional and personal to come to grips with the impact theseunspeakably terrible events have had on us, our families,friends, and co-workers. Then there are the more universalissues for our Nation, our safety, and the response of our gov-ernment to terrorism and the possibility of additional acts ofterrorism.

The answer really is that there is no way to make sense ofthese events. That 19 terrorists would commit suicide in orderto annihilate almost 6000 innocent human beings is totallyincomprehensible. However, we are all looking for ways to helpeach other through this tragedy and find a way to contribute, tohave something positive come out of this situation no matterhow modest. It is from this view point that we have asked anumber of our colleagues who responded to the disaster at thescene or within their institutions in New York City to summarizethe local or regional responses to the event and to delineatewhich programs and systems worked and which did not. Wesurmise that the lessons learned here also apply to the attackat the Pentagon, however there was no time to incorporatecomments from our colleagues in Washington, DC. We haveall learned a good deal about disaster preparedness andresponse from this event and much of it is universally applica-ble and well worth sharing.

Rick Nierenberg MD, Director, Jersey City Medical CenterEmergency Department, Assistant Professor of EmergencyMedicine

Jersey City Medical Center (JCMC) is a level II trauma cen-ter located directly across the Hudson River from the WorldTrade Center. We are an inner city teaching hospital with anED volume of 60,000 visits per year. Because of our locationwe received an initial influx of 150 patients over a very shorttime via ferry with little or no prior notification. Most of thesewere minor trauma patients although we did receive 12patients who were admitted with serious injuries. Unfortunatelydue to the lethality of the event very few additional casualtieswere seen subsequently although we maintained our disasterdeployment mode for the next 2 days.

Given that this was a medically compensatable event for usat JCMC, our deployment and operational status was gratify-ingly smooth and rapid. The hospitals and the community weregalvanized into a highly effective rescue force that could havetreated a great many additional patients had they survived toreached us.

The separation and treatment of the "walking wounded"from the critical ill and injured patient was accomplished by aremarkable effort to set up separate but contiguous facilities.Our auditorium was set up to serve as an expanded fast trackwhere our minor cases were sent from triage. Through priorplanning and ad hoc decision-making we deployed a series of"stations” in the auditorium. Thus we set up an eye stationstaffed by senior ophthalmologists and residents that was sup-plied with slit lamps and miscellaneous ophthalmic medica-tions and equipment. Our orthopedic personnel staffed a minorskeletal trauma station that was appropriately equipped for

bandaging and splinting. The Department of Medicine staffeda station that treated patient with respiratory and undifferenti-ated complaints. Our mental health professionals were onhand to speak with patients throughout their course. We com-pleted registration in the area and support personnel wereavailable to help the patient with communications and trans-portation needs.

This system functioned superbly and while providing expe-ditious care to our "minor patients" rapidly decompressed theED and allowed our emergency physicians and surgeons toconcentrate their resources on the major trauma cases andthe acute and critical patients from our community that werebrought in simultaneously.

Within our ED we were organized into treatment teamsconsisting of an emergency physician or a surgeon supportedby a resident and a member of the ancillary staff. Once wewere able to retriage the initial wave of patients to the audito-rium, we were able to focus on the needs of our multisystemtrauma patients. The Chief of Surgery was responsible forstaging the movement of trauma patients to immediate opera-tive intervention, delayed operative intervention or to an obser-vation area. This area also functioned very smoothly given thatour resources were never over taxed.

There were several areas of our response found to be lessthan adequate. Although our telephone system was intact,there were no open lines due to the massive number of callsbeing placed. We will need to create several back-up systemsfor both intramural and extramural communications. We dohave an ambulance base-station in our ED and this was themainstay of our communications during the first day of theevent. Portable telephones, zones phones, would have beenvery helpful, as would have been portable radios that allowedcommunication with the major triage and treatment sites in oursystem.

We discovered that our HAZMAT and Bio-terrorism con-tainment program has to be redesigned and reconfigured. Wehad relied on the HAZMAT services of our city FireDepartment for decontamination of incoming victims. However,if they are overwhelmed at the scene of the disaster or ifpatients bypass EMS and present directly to the ED, there hasto be a major decontamination, isolation and containment facil-ity deployed outside of the confines of the ED or the Hospital.

Dr. Stephen Menlove, Chair Disaster Committee BellevueHospital Center and Assistant Professor of EmergencyMedicine in Surgery

During the first 24 hours of the disaster we treated approx-imately 186 patients from the site. There was one death, 10patients required surgical intervention, 25 patients were admit-ted and 150 patients were treated and released. Some of ourresidents and faculty went to ground zero but the medicalneeds at the site were minor as all of the victims were rapidlyremoved to neighboring hospitals.

In general our response was very effective and our resourceswere never inadequate to meet the influx of patients. One of ourproblems was crowd control as so many of our medical profes-sionals gravitated to the ED to observe and to offer their servic-es. The telephones were constantly busy and communicationsbecame a significant problem. We will need to institute severalback-up systems. Registration bottlenecks were anticipated byusing blocks of preregistered disaster charts, but there were stilldelays in inputting patients into the system.

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Resident Group Discount Membership ParticipationDonald M. Yealy, MDUniversity of PittsburghSAEM Secretary/Treasurer

On behalf of the Board of Directors, I would like to thank the residency programs that have elected to participate in the resi-dent group discount membership. These 66 programs bring 1807 resident members to the Society. This program provides resi-dents with invaluable exposure to all facets of academic emergency medicine. Each resident member receives subscriptions toAcademic Emergency Medicine and the SAEM Newsletter, plus a discounted registration fee to attend the Annual Meeting. Theparticipating programs are:

Albany Medical CollegeAlbert Einstein Medical Center ProgramAllegheny General HospitalBeth Israel Deaconess Medical

Center/Harvard AffiliatedCarolinas Medical CenterCase Western Reserve

University/MetroHealth MedicalCenter

Christ HospitalChristiana Care Health SystemClarian - Methodist HospitalCooper Hospital/University Medical

CenterDetroit Receiving HospitalEast Carolina UniversityEmory UniversityGeorge Washington UniversityHennepin County Medical CenterHenry Ford HospitalHoward UniversityIndiana UniversityLong Island Jewish Medical CenterLouisiana State University - Charity

HospitalLouisiana State University - Baton

RougeM.S. Hershey Medical CenterMaricopa Medical Center

Mayo ClinicMedical College of VirginiaMedical College of Wisconsin

Michigan State University KalamazooCenter

Mount Sinai Medical Center/ElmhurstHospital Center

North Shore University HospitalNorthwestern UniversityOregon Health Sciences UniversityPalmetto Richland Memorial HospitalRegions HospitalResurrection Medical CenterSaginaw Cooperative Hospitals,

Inc./MSUSpectrum HealthSt. Luke's-Roosevelt Hospital CenterSt. Vincent Mercy Medical CenterStanford University/Kaiser PermanenteState University of New York at BuffaloState University of New York at Stony

BrookState University of New York Health

Science Center at SyracuseState University of New York Health

Sciences Center at BrooklynTexas Tech UniversityThomas Jefferson University HospitalUniversity of California, San Diego

UMDNJ-Robert Wood JohnsonUniversity of Arizona

University of ArkansasUniversity of Chicago

Hospitals/Lutheran General HospitalUniversity of Cincinnati Medical CenterUniversity of ConnecticutUniversity of LouisvilleUniversity of Michigan/St. Joseph Mercy

HospitalUniversity of New MexicoUniversity of PennsylvaniaUniversity of PittsburghUniversity of Texas Medical School at

HoustonUniversity of Virginia Health Sciences

CenterWake Forest University Baptist Medical

CenterWayne State University/Sinai-Grace

HospitalWayne State University/Detroit Medical

CenterWest Virginia UniversityWilliam Beaumont HospitalYale-New Haven Medical CenterYork Hospital/Pennsylvania State

University

Sign Up to Be a Medical Student Virtual AdvisorWendy C. Coates, MDCo-Chair, SAEMUndergraduate Education CommitteeHarbor-UCLA Medical Center

The Virtual Advisor Program was developed by theUndergraduate Education Committee in an attempt to providehigh quality advice to students who attend medical schoolswithout an associated EM residency program. Others may belooking for specific advice from someone in the geographicregion in which they wish to train. The academic faculty ofemergency medicine are in the best position to provide themost valuable advice to these students. If you already regis-tered at the Annual Meeting in Atlanta, you have already heardabout your new advisee(s) soon. If not, please visit the SAEM

website at www.saem.org where you can access the VirtualAdvisor home page. Please take a few minutes to complete the"Application to become an Advisor" and begin to share yourexperiences with a future member of our specialty. Be sure tolist your areas of expertise, as someone may be looking for amentor who shares the same interests. The future of our spe-cialty depends on our ability to attract bright students from allmedical schools. With your help, students can receive excellentcareer planning advice and be introduced early to academicemergency medicine.

Medicare Education and Regulatory Fairness ActPublished below is the text of a letter developed by the SAEM National Affairs Task Force, chaired by James Hoekstra, MD, thatwas sent to members of Congress on September 24 to comment on the Medicare Education and Regulatory Fairness Act.

The Society for AcademicEmergency Medicine (SAEM) repre-sents approximately 5500 academicemergency physicians practicing emer-gency medicine in academic medicalcenters and teaching hospitals through-out the U.S. SAEM welcomes theopportunity to support the "MedicareEducation and Regulatory Fairness Actof 2001 (MERFA)." These principles setforth in this Act are essential to ensurethat effective regulatory relief occursand that physicians and providers canexercise due process rights when facedwith contractor overpayment investiga-tions.

Emergency physicians and otherproviders are subject to more than132,000 pages of complex Medicarerules and regulations that are continu-ously changing. Under current law,Medicare providers must completeclaim forms, advance beneficiarynotices, certify medical necessity, fileenrollment forms, and comply with com-plex evaluation and management codedocumentation guidelines. In teachinginstitutions, the effects of these docu-mentation requirements are especiallyburdensome, interfering with our abilityto teach effectively as we spend moreand more time in the redundant andoften irrelevant documentation of servic-es in order to meet Medicare codingguidelines. These requirements canerode a physician’s ability to care forpatients and educate emergency physi-cians in training. SAEM is hopeful thatMERFA will provide some modestreforms to relieve us of these burdens.

The Medicare documentation andregulatory burdens have been exacer-bated by an audit system that assumesguilt for all physicians perceived to havefailed to follow Medicare guidelines.Physicians who make honest mistakesoften are treated as though they havecommitted crimes under the currentpractice. Specifically, MERFA will pro-vide modest reforms of the audit prac-tices of the Center for Medicare andMedicaid Services and provide educa-tion for medical providers on the com-plexities of Medicare billing. The billalso will prohibit collection of allegedMedicare overpayments until after aphysician’s appeal is heard. SAEM sup-ports this effort.

Evaluation and Management (E&M)Documentation Guidelines

E&M documentation guidelines havean extremely broad impact on physi-cians as they govern how physiciansmust document for office visits in orderto receive Medicare reimbursement. Todate, the Center for Medicare andMedicaid Services (CMS) has not beenable to set forth E&M guidelines to accu-rately reflect the services provided dur-ing an emergency department visit. TheE&M coding system does not accurate-ly reflect the decision making process inemergency situations. It rewards com-pleteness of documentation, not appro-priateness of rapid and critical interven-tion, which is so crucial to the practice ofemergency medicine. SAEM hasoffered its opinions in the past regardingthe E&M coding practice, recommend-ing a coding system based on chiefcomplaints, not final diagnoses or E&Mdocumentation of complete historiesand physicals. We welcome a chance torevisit this concept and discuss otheroptions with CMS at any time.

CMS is currently reexamining thedocumentation requirements. Webelieve that pilot tests are needed toensure that proposed new guidelinesaccurately reflect physician visits, andthat documentation requirementsshould not be implemented as nationalpolicy before pilot tests have been com-pleted. In addition, physicians partici-pating in a pilot test of any new guide-lines should not have the claims that arepart of the pilot test subject to beingdowncoded by the contractor or used asthe basis for audits. Protection duringtheir participation in the pilot projects isespecially important as the purpose ofthe pilot tests will be for both physiciansand carriers to learn whether the docu-mentation guidelines are appropriate.This limited protection is the only way toensure physician participation andaccurate documentation/coding in thepilot projects.

Documentation of PhysicianParticipation in Educational Settings

In teaching institutions, E & M codingrequirements force redundancy in docu-mentation between attending physiciansand residents or students. Emergencyphysicians are on duty in the emergencydepartment 24 hours a day, supervising

residents and students in the appropri-ate application of patient care.Residents and students are constantlyobserved and closely monitored.Unfortunately, the documentation of thatpresence by dictating or re-document-ing what the residents or students havealready done reduces our ability to edu-cate residents and medical studentsand take care of our patients.Redundant documentation of the "key"portions of those patient encounters orclinical procedures robs the student andresident of valuable time that could bespent teaching, or in further patientcare. In addition, it adds to inefficiencyin the academic ED and increasespatient lengths of stay, decreasing ourability to provide care to patients in needof our attention.

Due Process During Appeals We strongly urge Congress to estab-

lish a set of due process protections forphysicians and providers faced withcontractor post-payment audits. It mustbe emphasized that these audits are torecover alleged overpayments - not toproceed against suspected fraudulentbehavior – and that physicians andproviders in these situations should notbe required to waive their due processrights. We believe that the following ele-ments are essential to safeguard dueprocess rights:

Fair Repayment Plans Exhaustion of Appeals – Physicians/providers should not be forced to paycontractors for alleged overpayments(which can be hundreds of thousands ofdollars because of extrapolation) beforethey have exhausted their administrativeappeals. The length of time it takes tocomplete the appeals and the high per-centage of reversals of contractors’overpayment allegations illustrate theinequity of these repayment demands.If they choose to appeal, physicians andproviders should pay interest on theoverpayment allegations if their appealsare unsuccessful. Quite simply, webelieve that physicians and providersshould have the opportunity to exercisetheir due process rights before assum-ing financial liability.

Repayment Plans – Physicians/providers should be entitled to repay-ment plans if their overpayments

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exceed a certain threshold that wouldseverely impact the financial well-beingof the practice or provider. Contractorscurrently give physicians and providers30 days to repay overpayments in full(which can be hundreds of thousands ofdollars because of extrapolation).Unless the physician or provider hasdemonstrated in some manner that it isnot a reliable source of repayment, theyshould be given flexibility in repayingoverpayment amounts.

ExtrapolationWe are very concerned about the

contractors’ use of extrapolation fromprobe samples. Contractors conductthese probe samples on 15-40 claimsover a one to two year period and thenuse the alleged overpayment to extrap-olate to all claims submitted during thatone to two year period. Using 15-40claims in a probe sample over such along time period is not a valid method todetermine an alleged overpayment forthe rest of the claims. Contractor errorsregarding payment in the probe sample,which are often overturned throughadministrative appeal, can result inenormous extrapolated overpaymentallegations. Even more egregious, oftenthe first notice that physicians andproviders receive regarding allegedoverpayments is a letter demanding thisextrapolated overpayment amount. Westrongly urge the Congress to ensurethat extrapolation does not occur unlessthe contractor has provided prior, docu-mented education to the physician orprovider.

Reliable Pathways for QuestionsOne of the principal problems with

today’s Medicare system is that physi-cians and providers cannot obtain reli-able information about their questionsrelating to complex and confusingMedicare program guidances, programmemoranda, and regulations. The con-tractors will often not provide writtenconfirmation of conversations nor willcontractor personnel even release theirown names. Thus, physicians andproviders have nothing to rely upon ifthey are later audited for alleged over-payments. We strongly believe thatphysicians and providers must have aroute to obtain information from theircontractors upon which they can rely.Congress should create a mechanismto obtain this type of information aboutconflicting and confusing policies, whileensuring that those who ask questionsare not targeted for audits solely as aresult of their inquiries.

Voluntary Repayment Physicians and providers who receive

mistaken overpayments currently returnthese payments with the fear that theywill be audited by contractors simply forhaving returned the overpayment. Theserepayments, if they occur before they arenoticed by the contractors, should beencouraged. Physicians and providersshould not have to fear that they will beaudited for being good actors.

Random Prepayment AuditsWe strongly urge Congress to direct

the Secretary to establish uniform stan-dards for random prepayment audits.

Currently, contractors have completediscretion regarding how to structureand implement these random audits,and we believe that physicians andproviders should have guideposts withthe general conditions under whichthese audits may occur.

Application to All Providers,Physicians and Suppliers

We urge the Committee to ensurethat these reforms apply to all providers,physicians, and suppliers. All groupsare entitled to the same level of dueprocess protections and educationregarding Medicare’s complex rules andregulations.

In closing, we very much appreciatethe Committee devoting so much con-sideration to this issue. As you know,these problems have an impact on thevast majority of physicians andproviders – especially those with highMedicare patient populations. We urgeyou to ensure that the legislation emerg-ing from your Committee contains theprinciples listed above, and we look for-ward to working closely with you on thisand other issues in the coming months.

SAEM thanks you for the opportunityto express our views. We welcome theopportunity to discuss this issue withyou at any time.

Medicare Education (Continued)

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Newsletter Submissions WelcomedDavid C. Cone, MDEditor, SAEM NewsletterYale University

SAEM invites submissions to the Newsletter pertainingto academic emergency medicine I the following areas: 1)clinical practice; 2) education of EM residents, off-serviceresidents, medical students, and fellows; 3) faculty develop-ment; 4) politics and economics as they pertain to the aca-demic environment; 5) general announcements and notices;and 6) other pertinent topics. Materials should be submittedelectronically, preferably by e-mail to saem@saem.org. Besure to include the names and affiliations of authors and ameans of contact. All submissions are subject to review andediting. Queries can be sent to the SAEM office or directlyto the Editor at david.cone@yale.edu.

Residency Vacancy ServiceThe SAEM Residency Vacancy Service wasestablished more than ten years ago to assistresidency programs and prospective emergencymedicine residents. The Residency VacancyService is posted on the SAEM web site atwww.saem.org. Residency programs are invitedto list their unexpected vacancies or additionalopenings by contacting SAEM. SAEM monitorsand updates the listings. Prospective emergencymedicine residents are invited to review theselistings and contact the residency programs toobtain further information. Listings are deletedonly when the residency program informs SAEMthat the position(s) are filled.

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Yale University to Study ED Interventions for Hazardous DrinkingClifton Callaway, MD, PhDSAEM Research CommitteeUniversity of Pittsburgh

Yale University has received a three-year $2.3 million grantfrom the National Institute on Alcohol Abuse and Alcoholism(NIAAA) entitled "Emergency Physician Brief Interventions forAlcohol." Gail D’Onofrio, MD, an Associate Professor in theSection of Emergency Medicine, continues her career-longinterest in the impact of alcohol on ED patients as the PrincipalInvestigator for this award. Linda Degutis, DrPH, also anAssociate Professor in the Section of Emergency Medicine, isa co-investigator on the project.

At the beginning of this project, emergency physicians andphysician assistants at Yale will be taught a structured 5-7minute brief intervention for patients with hazardous or harm-ful drinking. During a subsequent intervention phase of thestudy, ED patients will be screened for excessive alcohol con-sumption using a survey. Once a patient with hazardous orharmful drinking has been identified and consented to thestudy, that subject will be randomly assigned to receive thebrief intervention from the physician or to receive standard dis-charge instructions and referrals. These subjects will receivetelephone follow-up at 1, 6 and 12 months to assess the sta-tus of their drinking behavior, and their use of health-relatedservices. The study will test the hypothesis that the interven-tion can reduce total alcohol consumption, reduce the fre-quency of binge drinking and increase utilization of primarycare related services. The investigators will also begin toexamine whether the intervention can reduce subsequent EDvisits and hospitalizations for the subjects.

This project is the culmination of a series of investigationsfocusing on the role of alcohol in ED patients. Dr. D’Onofriostudied alcohol-related seizures in Boston, receiving somesupport from a Boston University Biomedical Research Grant.That work led to a track record of publication in the area ofalcohol effects on health, including a high-profile article in theNew England Journal of Medicine (1999; 340:915-919).Further background for this project derived from a Center for

Substance Abuse Prevention (CSAP) fellowship, reports Dr.D’Onofrio. That experience helped introduce her to the net-work of investigators with similar interests and to the method-ologies central to this field. Similar experience may not havebeen available without stepping outside the boundaries ofEmergency Medicine.

Close collaboration with specialists in other areas will becentral to the success of this project. The brief interventionhas been adapted from interventions previously described (forexample, Acad Emerg Med 1998; 5:1210-1217 ). The input oftwo collaborating internists and a psychologist have helpedwith that development. Statistical refinement was accom-plished with the help of a senior biostatistician at Yale with spe-cial interest in substance abuse. This team of investigatorsmeets regularly to share their particular expertise and to keepthe clinical trial on track.

Receipt of this funding will allow the research endeavor inthe section of Emergency Medicine to grow in several ways. Afull time project director and five research associates will behired specifically for this project. In addition, funding will helpprotect some of the academic time for Dr. D’Onofrio and Dr.Degutis. Such protection will be critical for balancing clinical,teaching and administrative duties with the investigativeresponsibility.

Information Sought on FederallyFunded Projects

If you are a Principal or Co-Investigator for a currentprogram or project grant supported by NIH, AHRQ, CDC orother federal funding, we invite you to notify the ResearchCommittee of your project on an ongoing basis. TheResearch Committee activity will try to publicize newprojects in Emergency Medicine research to acknowledgesuccess in achieving funding, and to point out resources for members seeking expertise in particular fields.Send information to Clifton Callaway, MD, PhD atcallawaycw@msx.upmc.edu.

Report on Task Force on Weapons of Mass DestructionEdward J. Otten, MDSAEM Representative, Task Force onWeapons of Mass DestructionUniversity of Cincinnati

The Task Force on Weapons of MassDestruction (WMD) was formed inresponse to a perceived need of theUnited States Government that themedical community might not be pre-pared to respond to terrorist attacks onthe US population. In 1996-97 theCongress passed the Defense AgainstWeapons of Mass Destruction Act alongwith the Nunn-Lugar-Domenici amend-ment that authorized $10 billion dollarsto remedy this problem. As happens inthese cases hundreds of “experts” in

WMD vied for those funds. Unable tosort the wheat from the chaff, the Officeof Emergency Preparedness asked theAmerican College of EmergencyPhysicians (ACEP) to assemble a taskforce to look at the various programs,courses, training materials and curriculato determine the optimal program fortraining EMS personnel, physicians andnurses in how to respond to WMD inci-dents. Fourteen national organizationsrepresenting police, fire, rescue, physi-cians, toxicologists, nurses and adminis-trators and guided by the Office ofEmergency Preparedness and ACEPtook on this task. Although I belonged tothree of the organizations, I representedSAEM on the Task Force. We met eight

times over two years and produced a140 pages document entitled“Developing objectives, content andcompetencies for the training of emer-gency medical technicians, emergencyphysicians, and emergency nurses tocare for casualties resulting fromnuclear, biological, or chemical (NBC)incidents’. This document collects, sum-marizes and expands on the entire fieldof WMD training in the US and giveseducators a “go by” to evaluate varioustraining programs and eventually willbecome the gold standard for all suchprograms. SAEM should continue toparticipate in projects such as these inthe future since our input and expertiseare needed.

Academic Pathways and Research Funding Opportunities for EM

T. Paul Tran, MDSAEM Research CommitteeUniversity of Nebraska Medical Center

As articulated by recent SAEM presidents, academic emer-gency medicine needs a cadre of young academicians dedi-cated to the exploration of fundamental physiological andpathological processes that will ultimately lead to improvedemergency care. These young emergency academicians mayface major barriers in their academic journeys, not the least ofwhich is getting funding support.

There are generally three ways to progress in academics:the clinician pathway, the educator pathway, and the researchpathway. While any of these is equally viable, the "rules of thegame" for academic advancement still require research grantsand publications. Time and again, obtaining effective mentor-ship, defining a focused area of interest, finding a supportiveenvironment, developing time management skills, and obtain-ing grants are some of the most critical ingredients for success.In an environment of continuing fiscal constraint and compet-ing clinical demands, obtaining initial grant support can be atremendous motivation in this long journey but requires carefulplanning.

The gold standard of biomedical grant funding is extramu-ral support from the NIH. Clinically oriented scientists canapply for the Mentored Patient-Oriented Research CareerDevelopment Award (K23). This award supports the develop-ment of investigators who wish to conduct patient-basedresearch. The research can be in mechanisms of disease,therapy, clinical trials, or development of new technologies.Funding support ranges up to $75K/yr (plus fringe benefits) for3-5 years; however, applicants must be prepared to spend75% of their time on the research effort. Mentorship is impera-tive. Applicants must work with a mentor who has extensiveresearch experience and a proven track record in the area ofresearch.

Laboratory-oriented scientists can apply for the MentoredClinical Scientist Development Award (K08). This award sup-ports development of clinically trained investigators to performlaboratory or field based research. Again, mentorship is criti-cal. It is expected that at the end of the grant period, investi-gators will be able to perform independent research. Eligibilityrequirements and support vary among the 15 NIH institutes.Generally support ranges to $75K/yr (plus fringe benefits) for3-5 years. Again, applicants must spend 75% of their time onthe research effort. More web resources for both the K08 andK23 awards can be found at www.nih.gov and the supportinginstitutes. Application forms can be obtained on line athttp://www.grants.nih.gov/grants/forms.htm#training and areaccepted February 1, June 1, and October 1.

Two RFA’s (Requests for Applications) that may be of inter-est to researchers in EM were released by the NIH inSeptember 2001. The first is RFA-AA-02-004 from the NationalInstitute on Alcohol Abuse and Alcoholism requesting propos-als in basic research for the development of pharmacothera-peutic agents for alcoholism, alcohol abuse, and alcohol-relat-ed medical consequences (http://grants.nih.gov/grants/guide/rfa-files/RFA-AA-02-004.html). The letter of intentreceipt date is December 28, 2001 and the application receiptdate is January 23, 2002. The second is RFA-HL-02-003 fromthe National Heart, Lung, and Blood Institute requests propos-

als in basic research to improve cardiopulmonary and neuro-logical outcomes following resuscitation from cardiopulmonaryarrest (http://grants.nih.gov/grants/guide/rfa-files/RFA-HL-02-003.html). The letter of intent receipt date is January 10, 2002and the application receipt date is February 12, 2002.

The Emergency Medicine Foundation (EMF), the educationand research arm of ACEP, also provides grant support forindividuals. These include: 1) The Creativity and Innovation inEmergency Medicine grant ($5K) designed to provide supportfor time relief or minor equipment purchase for new/seasonedinvestigators with an innovative research idea. The next dead-line is December 12, 2001, 2) The EMF Research Fellowshipgrant ($35K) which provides support for EM residency gradu-ates who wish to spend one year to pursue further training inresearch methodology. The next deadline is January 11, 2002,and 3) The EMF career development grant ($50K). This pro-vides seed money for investigators at the instructor or assis-tant professor level on their way to becoming independentresearchers. The next deadline is January 11, 2002. More webresources for EMF programs can be found athttp://www.acep.org/2,1628,0.html

The Society for Academic Emergency Medicine (SAEM)also administers a number of grants. The SAEM ScholarlySabbatical Grant (http://www.saem.org/awards/sabbatic.htm)provides support up to $10,000/month for 6 months to EM fac-ulty at the assistant professor level or higher for release time todevelop skills for career advancement. The SAEM ResearchTraining Grant, formerly known as the Resident Research YearAward (http://www.saem.org/awards/research.htm), is a two-year grant that provides $75,000 per year. Other SAEMresearch grants are the Neuroscience Research FellowshipGrant ($50K) sponsored by AstraZeneca (http://www.saem.org/awards/neurores.htm), and the EMS Fellowship ($60K),sponsored by Medtronic Physio Control (http://www.saem.org/awards/02ems.htm). The deadline for all these applications isNovember 1, 2001.

The American Heart Association (AHA) is an importantsource of funding for investigators in cardiovascular research.The research area broadly covers cardiovascular function anddisease, stroke, or related basic science, clinical, bioengineer-ing/biotechnology, and public health problems. Two AHA lev-els of support are available: affiliate and national. Investigatorscan apply to both during the same cycle. Web resources forAHA programs can be found at: http://www.americanheart.org/research/app/appintro.htm

At the national level of the AHA are two important grants forbeginning investigators. First is the "National ScientistDevelopment Grant," which provides support for investigatorson their way to being independent investigators. Applicationdeadlines are January 14, 2002 and July 15, 2002. Second isthe "National Fellow to Faculty Transition Award," which pro-vides support for the faculty in the early years of their first fac-ulty position. The application deadline is January 14, 2002.Independent investigators can apply for the "NationalEstablished Investigator Grant" or "National Grant-in-Aid."

At the affiliate level, young investigators can apply for the"Beginning Grant-in-Aid" designed to help beginning scientiststo reach independent status. For independent investigators,the "Affiliate Grant-in-Aid," provides support for the most mer-itorious research projects. Investigators should apply to theappropriate local AHA affiliate office.

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Summary of the Successful Researchers Project

Jeffrey A. Kline, MD Carolinas Medical CenterCraig D. Newgard, MD, MPHHarbor-UCLAon behalf of the SAEM Research Committee

As the specialty of emergency medi-cine (EM) grows, our research effortsbegin to have a larger impact on societyat large. This impact is only possiblethrough the efforts of individualresearchers. Each year, more younggraduates in the field of EM seek tomake a difference through contributionsin research, and as their ranks grow, sodoes the competition to become recog-nized as EM academicians.

Many young researchers have ques-tions about how successful contempo-rary EM investigators reached their cur-rent status and the path that led themthere. While it is self-evident that theprocess of achieving academic successis a complex process that cannot bequantified by a mathematical model, wehypothesize that certain components totraining, access to knowledge, technicalskill, funding, motivation, and communi-cation skills are required for aresearcher to achieve high merit. Thepurpose of this project was to investi-gate which factors and traits are sharedby a group of successful researchers,and the extent to which these factorshave contributed to research successfor these individuals. To achieve thisgoal we conducted a structured inter-view with a sample of 10 successfulresearchers in the field of EM. Thoseinterviewed included:

Lance B. Becker MD, University ofChicago

Michael Callaham, MD, University ofCalifornia at San Francisco

Carlos Camargo, Jr., MD, DrPh,Massachusetts General Hospital

E. John Gallagher, MD, Albert EinsteinMedical Center

Jerris R. Hedges, MD, MS, OregonHealth Sciences University

Jerome R. Hoffman, MD, UCLAEmergency Medicine Center

Gabor D. Kelen, MD, Johns HopkinsUniversity

Arthur Kellerman, MD, EmoryUniversity

Roger J. Lewis, MD, PhD, Harbor-UCLA Medical Center

Each investigator was asked a seriesof 10 questions, shown in Table 1. Table

2 summarizes the results of these inter-views, with the ten subjects numberedrandomly.

Among the ten investigators inter-viewed, five are current Chairs or Chiefsof their departments/divisions and allhold at least the appointment ofAssociate Professor. The mean age was49±10 years, and the investigators havebeen practicing EM for a mean 12±6years.

The interview process demonstratedthat among the 10 successful EMresearchers, there was no predominantself-perception as to what actually con-stituted "a most important researchaccomplishment." Several of the inves-tigators identified objective achieve-ments such as the development of studyconsortiums, publications, or positionsheld. However, they also indicated thatintangible contributions to our specialtyare extremely important. This findingsuggests that one of the keys to internaland external validation regarding a suc-cessful career in EM research lies inindividual values, rather than accom-plishing specific goals such as publish-ing a high-profile article, or being award-ed a large grant.

The aggregated responses also sug-gest that researchers require a longtime to reach the research goals thatinstill satisfaction. The mean require-ment was 7.9 years ± 3.2 (SD) years,with a range of 3 to 12 years. Most ofthe investigators were hesitant to definea specific endpoint in their research andall indicated that their research was anongoing effort. Again, we interpretthese responses as evidence that satis-faction from a career in research growsmore from the process of learning thanfrom any specific endpoint.

Another clear message was theimportance of mentoring. Five of tenrespondents ranked mentoring as thesingle most important aspect to theirtraining. With respect to the optimalqualification of a mentor, the majority ofrespondents felt that the most importantaspect of mentoring was mutual respectand the overall relationship between thementor and the mentee. It was evidentfrom these interviews that the mentormust have adequate time in order tomake an important contribution to ayoung researcher's development. As forfellowship training, the investigators feltthat pursuing a fellowship was alwayshelpful, however only a minority indicat-

ed that fellowship was a mandatoryrequirement for success in EMresearch. This finding implies that therelationship between an establishedresearcher and a researcher-in-trainingmay be more important than the contextand formal description of that relation-ship. Interestingly, when posed with thequestion of what could have been donedifferently in their research careers, fourof ten would have sought fellowshiptraining or mentoring earlier in theircareer.

The majority of these establishedinvestigators derived their initial fundingfrom industry. However, it should benoted that many of these researchersstarted out in the late 1980's, and sincethat time, EM has made great strideswith many more researchers receivingfederal funding. It was evident from theresponses that all of the sampled inves-tigators now consider federal funding tobe one of their most important sourcesof research funding. While the investi-gators sampled suggested that industrywas likely to be a primary source offunding for up and coming researchersin the next 5 to 10 years, all felt that highquality EM research would continue tobe federally funded.

There was no consensus as to whatSAEM should be doing differently toimprove the development ofresearchers. However, potential areasto further develop are the availability ofresearch funding, enhancing the expo-sure of EM researchers to the NIH, andimproving communication betweenestablished researchers and younginvestigators.

Half of the investigators expressedconcern over the process of promotionand tenure and its effect on publicationrecord. Specifically, there was concernthat the process of promotion oftenforces young investigators to publish toomany small papers, which have littleimpact. This finding raises the questionof whether promotion should be linkedto the impact of the research effort onbetter understanding mechanisms ofdisease or patient outcomes, ratherthan simply to quantitative productivity,the latter of which is often the case.

It should be noted that the list of thesuccessful investigators was derivedarbitrarily, based on specific criteria,consensus of members of the ResearchCommittee, and availability for interview.This list is only a sampling of successfulinvestigators, is not meant to be com-

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Summary of the Successful Researchers Project (Continued)prehensive, and is not meant to indicate that these researchers are in anyway the ten "best" EM researchers. Surely, our spe-cialty has growing numbers of prominent investigators and academicians that deserve to be recognized, but are not included inthis sample. We regret that there were no women included in the list, and that few researchers who perform basic science wereincluded. We hope that future work may focus on and recognize these individuals as well.

In summary, this project suggests that successful researchers do not necessarily perceive their specific public accomplish-ments to be their highest honor. Many indicated intangible aspects to the process of learning and teaching to be equally or moreimportant than grants, positions or publications. The majority of successful investigators in this sample indicated that mentoringwas the most important element to success in EM research and that the young investigator should conduct a vigorous search forthe ideal mentor.

Table 1. Survey questions.1. What do you consider to be your highest research accomplishment?2. How long did it take from the time you first had this goal, to the time you reached it?3. Please rank these issues in order of importance for reaching your research goal: mentoring, seed money, protected time, col-

laborative support, your personality, fellowship training, writing skills, luck, intelligence. Elaborate on what you think is mostimportant and why.

4. Please elaborate on the second most important factor that allowed you to reach your accomplishment.5. What advice would you give a young researcher looking for a mentor?

How do you decide who is a good mentor?6. Has fellowship training become a necessity for a young researcher to become successful in EM research?7. Where have you derived most of your research funding?8. Where do you think the majority of funding for young investigators involved in EM research will come from in 10 years?

Foundations, Industry, or Federal?9. If you had a time machine, what decision would you change, or what would you have done differently about your research

career? 10. What should SAEM be doing to help young researchers?

TEN SUCCESSFUL INVESTIGATORS (in random order)

Question 1 2 3 4 5 6 7 8 9 101. Highest accomplishment 5 3 2 2 4 1 2 5 4 4

2. Time to reach,(years) 6.5 10 5 10 12 2.5 3 8 10 103. Most important factor mentoring mentoring mentoring colleagues motivation mentoring motivation mentoring fellowship training protected time4. Second most important motivation collaboration motivation protected time writing skills protected time collaboration protected time luck mentoring5. Mentor: via national self-initiate self-initiate via fellowship self-initiate self-initiate self-initiate self-initiate self-initiate self-initiatea. method to find meeting contact contact contacts contact contact contact contact contact contactb. qualifications 1 2 3 1 3 3 1 1 1 36. Fellowship required? 1 1 3 2 1 2 3 2 3 27. Funding source 1,3 1,3,4 1,4 4 1 2,3 1,2,3 4 4 28. Future funding 1 1,2 1,2 3 1 3 1 1,2,3 3,4 3,49. What would do over committed epidemiology fellowship fellowship find mentor more first fewer small additional grad nothing fewer small projectsdifferently on speaking degree sooner authorship projects courses10. What should SAEM do? sponsor enhance enhance smaller enhance enhance sponsor sponsor target federal enhance

sabbatical connections mentoring meetings connections connections research research funding connections

KEYAccomplishment Fellowship Funding source Mentor qualifications1=methodology 0=low importance 1=industry 1=mutual respect, good relationship, likable, availability2=study group 1=helpful 2=foundation 2=shared interest and passion for a topic

or consortium 2=almost required 3=NIH 3=publication history, expertise, and name recognition3=position held 3=mandatory 4=other federal4=funding OR

publication5=mentoring

Table 2. Tabulated responses from the 10 investigators.

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ACADEMIC RESIDENT

Adapted from a presentation byWilliam Cordell, MDIndiana University

We are sensitive to the many demands placed on residentphysicians during their post-graduate training. Why then towe require the completion of a scholarly project during theresidency?

First, it is required by the Residency Review Committee(RRC). The RRC residency requirements state: "The cur-riculum should include resident experience in scholarly activ-ity prior to completion of the program. Some examples ofsuitable resident scholarly activities are the preparation of ascholarly paper such as a collective review or case report,active participation in a research project or formulation andimplementation of an original research project. Residentsmust be taught an understanding of basic research method-ologies, statistical analysis and critical analysis of currentmedical literature."

More importantly, we strongly believe there are importantskills a resident should acquire during post-graduate training.These include tools for life-long learning, an understanding ofhow to use medical research and basic research concepts,an awareness of the importance of information managementin healthcare, and the application of evidence-based medi-cine (EBM) skills. These EBM skills include formulating ques-tions, searching for answers, critically analyzing research toweigh the evidence, and applying the evidence to the care ofpatients or populations.

Scholarly Activity OptionsTo fulfill the Scholarly Activity requirement, each resident

must participate in or complete one of the following by theend of his or her residency:� Original research project: The resident serves as princi-

pal investigator, co-investigator, or a sub-investigator on aproject. It is important to define the exact role you will playin the project. If you are joining a project as a sub-investi-gator, be certain that this will meet graduation require-ments from your Program Director.

� Evidence-based Medicine Critically Appraised Topic("CAT"): The resident chooses a clinical question, search-es the literature for pertinent articles, and writes approxi-mately 10 one-page critiques in the style of ACP JournalClub. These articles and reviews are assembled in a note-book and filed for future use by the training program.

� Product invention/development: The resident designs amedical product/device. A written description and proto-type or product are required. In addition, the resident willreview the patent process and protection of intellectualproperties.

� Computer project: The resident designs a computer pro-gram or educational project. A written description andcompleted prototype or product are expected end points.The resident reviews the process for protecting intellectual

properties.� Practice guidelines: Using evidence based medicine

skills, the resident investigates a clinical question, search-es for pertinent articles and/or previously-written guide-lines, assesses their validity, and develops a departmentalpractice guideline. Example: "What are the indications forprescribing antibiotics to patients with acute bronchitis?"

� Case report: A publication-ready manuscript is normallyrequired.

� Collective review: The resident identifies a topic, per-forms a literature search, and prepares a manuscript fol-lowing the style of the major EM journals.

General Instructions� All projects should have a faculty sponsor/mentor

(Emergency Medicine, Trauma, Radiology, etc.). Try topair up with a faculty member who is initiating a project orone who shares an interest in your topic of research.

� There should be contacts (e.g. research director)within your residency faculty who can assist in pairing yourinterests with appropriate faculty from EM or other disci-plines, as well as biostatisticians to help formulate theproject and assist with the mechanics.

� Collaboration with other EM residents (especially thosewho will graduate after you) or residents from other depart-ments should be considered. This helps spreads the workload and promotes continuity (e.g. if data collection takeslonger than anticipated, your project will not wither on thevine after you graduate). The down side is that you havelittle leverage with a peer or colleague from another disci-pline if they fail to do their work.

� Keep the project simple and doable. The first step is for-mulating an answerable question. This is perhaps themost frequent mistake made by novice researchers! Yourgoal is to contribute a small piece of information to themedical community, not win the Nobel Prize.

� Focus your energies. Pick one topic you’re interested inand complete it. The tendency is to be interested innumerous topics and getting none really going.

� Set a time table early. Projects almost invariably takelonger than anticipated (usually twice as long as anticipat-ed…three times for research projects since they must gothrough the IRB/animal use committee). Good scholarlyactivity projects cannot be started and completed by"pulling an all-nighter."

� Initiation and completion of the project is the responsibilityof the resident and is a requirement for graduation. Yourprogram director should have established guidelines aboutwhat is and isn’t acceptable…incorporate this into yourplanning.

� Consider taking an Emergency Medicine Research elec-tive. At least three weeks of the month must be allocatedfor project completion.

News and Information for Residents Interested in Academic Emergency Medicine

Edited by the SAEM GME Committee

WHAT IS THE EMERGENCY MEDICINE SCHOLARLY ACTIVITY REQUIREMENT?

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My Two Cents on Scholarly ActivityRita K. Cydulka, MD, MSMetroHealth Medical Center

The other day I received by e-mail a survey from a residentwho was completing his scholarly project requirement. The sur-vey asked a number of personal questions and questions aboutmy medical history. The survey was not accompanied by a coverletter explaining the purpose of the survey, a copy of IRBapproval to query physicians across the internet about very per-sonal information, a section that details the privacy and confi-dentiality issues, or what prior research has revealed about thisparticular issue. Unfortunately, the survey was typical of manysurveys that I receive from residents in an effort to completetheir required scholarly activity. The surveys are frequentlyhastily compiled, not reviewed by a survey methodologist, andnot approved by the hospital’s IRB.

According to the Program Requirements for ResidencyEducation in Emergency Medicine, put forth by the AccreditationCouncil for Graduate Medical Education, emergency medicineresidency must include "…provision of support for resident par-ticipation in scholarly activities. The curriculum should includeresident experience in scholarly activity prior to completion ofthe program. Some examples of suitable resident scholarlyactivities are the preparation of a scholarly paper such as a col-lective review or case report, active participation in a researchproject, or formulation and implementation of an originalresearch project."

In my experience, the most common ways that residentsattempted to fulfill this requirement were by writing literaturereviews, case reports, or conducting surveys. In my eight yearsas a co-residency director and residency director, I went frombeing very enthusiastic about the scholarly activity requirementas an opportunity for emergency medicine residents to see ifacademia was the right choice for a future career, to realizingthat rigors of residency training barely allow enough time for oneto become a skilled clinician, read at least one emergency med-icine textbook cover-to-cover, and keep up with the medical lit-erature, while trying to maintain some type of balance outside ofresidency. I also realized that the length of most programs (3years) allows for few electives and even less time for dedicatedresearch months. As a result, most of the scholarly activity per-formed is squeezed in during "days off" and hastily completed.Although some residency programs are able to implement asuccessful research program and consistently recruit residentswho are able to complete high quality projects during their train-ing, I have found this to be the exception, rather than the rule.

The purpose of this discussion is not to offer my opinion onthis requirement and whether it serves the purpose it seeks toaccomplish, but to provide helpful suggestions for those trying tofulfill the requirement. Therefore, this discussion will be aimed atoffering helpful suggestions for those residents choosing to writeliterature reviews, case reports, or conduct surveys in fulfillmentof the requirement. A discussion of observational trials andexperimental trials is beyond the scope of this discussion.The Literature Review

The two types of literature review that I have seen publishedby residents are literature reviews for peer review journals whichcite hundreds of articles pertaining to a single subject, and theclinically based literature review, such as those found in looselyreviewed – but practical – resources, such as computer basedtexts, etc. that are clinically oriented and designed for use in theemergency department. Performing either type of review forcesthe resident to obtain a deep fund of knowledge on the subject

about which he/she is writing but neither of these forces the res-ident to critically review the articles for methodological quality,content, and relevance to emergency medicine practice.

A systematic literature review, on the other hand, is a litera-ture review in which evidence from scientific studies is located,evaluated and put together using a well defined scientific design.In fact, the design by which the literature for a systematic litera-ture review has been selected must be reported in the paperitself. The aim of a systematic literature review is to provide acomprehensive and unbiased manuscript that can be used forimportant decisions in the delivery of health care. Systematic lit-erature reviews include studies that have not been published butwhich may have an important effect on the conclusions that aredrawn, as well as published studies. This means that the resi-dent must be familiar with the field of study and contact expertsin the field to discuss unpublished data. A well done systematicliterature review will take a resident about a year to completewith proper guidance from a faculty member who is trained inthis methodology.

The following stages should be followed in completing a sys-tematic literature review:� Identify a subject of interest and a question that you wish to

answer.� Make sure that a systematic review on the subject has not

been recently published.� Determine how you are going to review each article.� Decide the requirements to include an article in your literature

review.� Do a literature search and retrieve all relevant articles.� Read all the articles and assess them for inclusion in your

review based on:� Relevance to your question/subject.� Your inclusion criteria.� Study validity.� Extract the data from each study for inclusion in your data

tables.� Analyze the data using meta-analysis approach � You will need someone trained in this area to help you here.� Write up the manuscript.� Have a faculty member who is trained in this area review the

manuscript.� Edit the manuscript � Repeat above two steps until both the resident and faculty

member are satisfied with the manuscript.� Submit the manuscript.Case Reports

Case reports are usually derived from an interesting andunusual clinical observation. They tend to describe the present-ing signs and symptoms of a disease, its progress, or itsresponse to therapy and may contribute to the identification ofnew diseases, outcomes of treatment, and recognition of previ-ously unrecognized associations and causes of rare diseases.In fact, case reports are frequently the means by which adversereactions to drugs are first identified.

The advantages of doing a case report are: they are easy todo and, on rare occasions, may disprove an accepted hypothe-sis if the case report involves the exception to a previous rule.The weakness of case reports are that they commonly focus oncases which are unusual, which means that the finding mayhave little practical importance and may not be generalizable.Case reports are definitely not a method for answering researchquestions and should always be considered as a preliminary

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observation.In order to develop a case report, the case must be interest-

ing and have at least one novel element that is previously unre-ported. This unusual feature might be the ultimate diagnosis,the method of diagnosis, the treatment, or the complications ofthe treatment. After you have selected your case, furtherresearch is necessary. Begin with a literature search on thesubject. Read through all the relevant literature before you startto write. As you read, take notes on relevant points of the liter-ature including study methodology, conclusion, relevance toyour case, and quality of the study. The discussion shouldinclude relevant features of the case and how you place thesefindings in the context of the published literature. As you workthrough your case, compare each fact of your case to previous-ly published data. If the findings match those previouslydescribed, state this. If the case you are describing is unusual,try to provide a logical explanation of why and how the man-agement of the case was altered. This should also be done foreach abnormal clinical finding or laboratory result. The discus-sion should also include a few paragraphs explaining the "whocares" aspect of the case. In other words, explain to the readerwhy you are reporting this case, why they should be interestedand how it is relevant to their clinical practice.Surveys

Surveys in health care have been used to determine knowl-edge and experience of physicians, activities that physiciansperform, educational needs, need for patient services, healthbeliefs and behaviors, training and experience of staff, as well asa myriad of other questions. According to the Section on SurveyResearch Methods of the American Statistical Association, thefollowing steps should be taken when designing a survey:� Determine very clearly what it is you want to measure.� Generate an item pool using literature review, focused group

discussions, expert reviewers, and validation items.� Determine the format that you are going to measure the

responses � What type of scale are you going to use?� Have the initial items reviewed by experts.� Consider including validation items in your questionnaire.� Pilot the items in a development sample to a small number of

people.� Evaluate the items that you have piloted.

A well planned, newly developed survey will take well over ayear to complete. Before beginning a survey, decide who yourgroup of interest is. It is very important that the participants inyour survey are representative of this broad group of interest.Next, a list of possible participants must be obtained. If the listof participants is too large for everybody to be studied, a sam-ple should be taken from this list. It is very important that thereis an accurate list from which the sample is drawn so that: 1)people aren’t forgotten; 2) all people have an equal chance ofbeing included in the sample. The most common methods ofchoosing a sample are 1) convenience sampling, which consistsof selecting those participants that tend to be easy to include; 2)simple random sampling, which means every possible partici-pant will have an equal chance of being selected for the sample;3) systematic sampling, which means determining a systematicway of choosing participants, i.e. selecting every 20th person ona list to participate.

Surveys are not immune to proper research methodology. Asample size must be decided. It is best to ask a statistician orsomeone familiar with calculating sample sizes in order to col-

lect a proper number of responses.Next, the method of sampling must be decided: will it be elec-

tronic surveying, telephone surveying, mail survey, in-personinterviewing? Self-administered questionnaires are more eco-nomical than interviews and more easily standardized. Close-ended questions are usually easier to answer and easier to ana-lyze. The instrument should be simple and easy to read. Allquestions should be proceeded by clear instructions and exam-ples. The answers to close-ended questions should be coded inadvance and the codes and score should be organized on theform in a way that would make data entry simple and efficient.Residents should make an effort to use existing tools that areknown to produce accurate and reliable results. Remember toput sensitive questions later in the survey so those respondentsare not immediately put off by your questions. The instrumentsshould be pre-tested before being used in the study. The pretestwill help refine the actual survey.

Once the survey has been pilot tested and is ready to mail,residents should plan on a way to track responses. Several mail-ings and/or calls are usually needed in order to achieve anacceptable response rate to their survey.The data must be entered in a systematic fashion and must bechecked to ensure that all forms are completed. Missing data orinappropriate answers should be followed up on. An experi-enced analyst should analyze the data. Of course, no project iscomplete until it is published so that the knowledge gained canbe shared with others. Manuscript preparation for surveys issimilar to that described above.

Common problems in survey studies include the following:poorly defined research questions and too many items on thesurvey. It is essential to refine the research question and focusit. A survey that is too long, unfocused, and poorly written willhave a poor response rate. Remember, the persons who youare surveying are busy and will only respond if they feel that theinformation they are providing to you is meaningful.Final Thoughts

Scholarly projects that are well done contribute significantlyto the medical literature. They are intended to introduce resi-dents to research methodology and allow residents to experi-ence first hand the excitement of completing a project from ideato publication. Ways to increase the likelihood of conducting asuccessful project include the following: studying something thatpeople care about, developing a focused project, proper plan-ning, sound methodology, a pilot trial, support from your facultyadvisor / mentor and the persons whom you are involving in thestudy, and adequate resources and expertise to complete theproject. On occasion, performance of a successful researchproject is career altering as the process excites persons whomay never have considered a research career to pursue one. Iknow that this was certainly the case with me.References1. http://www.acgme.org/index.htm 2. Crombie IK, Davies HTO: Research and Health Care Design,

Conduct and Interpretation of Health Services Research.John Wiley and Sons, New York, 1997.

3. Hulley SB, Cummings SR: Designing Clinical Research: AnEpidemiologic Approach. Williams & Wilkins, Baltimore,1998.

4. ASA Series: What is a Survey? Section on Survey ResearchMethods. American Statistical Association. Alexandria, 1997.

5. Cydulka R, Davison R, Grammer L et al: The use of epineph-rine in the treatment of older adult asthmatics. Ann EmergMed. 1988: 17 (4): 322 – 6.

My Two Cents (Continued)

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Resident Work Hours: An EM Resident's PerspectiveJill A. Grant, MD SAEM National Affairs Task ForceUniversity of Virginia

What is it about human nature thatdrives us to succeed, to push ourselvesto the furthest physical and mental lim-its? Is it the fear of failure? Is it embar-rassment that we won’t stand up to ourpeers? Is it the push we receive fromour parents or mentors? Or is it simplyan inherent drive to achieve that whichwe hold deep in our hearts? No matterwhat the focus point for success on thepath to becoming a physician, includingmedical school, internship, and residen-cy, it is impossible to avoid the physicaland mental strain caused by the stress-es of a new environment, new situa-tions, long work hours, and immensenew responsibilities. Residency is alearning environment, and ongoingreading and research are critical formaking us better physicians. It is over ashort period of time in this environmenthowever, that a resident’s mental andphysical stamina are pushed to the limit.Mental and physical fatigue settle in,decision trees are limited, and residentsare frequently left with instinct, some-thing which has not been given ampletime to develop. Patients are now at riskof harm or death based on resident-administered treatment. This scenarioillustrates why SAEM must address theneed for limits on resident work hours toensure not only quality patient care butalso a productive educational work envi-ronment and physician well being.

Residency training should balancework with education to produce compe-tent and caring physicians. Sleepy, over-worked residents are more prone tomaking medical errors. In fact, onestudy cited in JAMA in 1991 found that"41% of 145 residents surveyed citedfatigue as a cause of most of their mostserious mistakes." And even more wor-risome is that in nearly one-third ofthese cases, patients died as a result ofthe error. Unfortunate as this is, thepatient is not the only one placed at risk,so is the resident. Studies have shownthat sleep-deprived physicians-in-train-ing are at increased risk of being in anauto crash, suffering from depression,or giving birth to premature infants.Being overworked is also not conduciveto medical education. With such a busywork schedule it is difficult to find time toread without falling asleep. Additionally,

some of the best learning occurs whileat work, on rounds, and through confer-ences and lectures, but again fatigueand overwork frequently interfere withreception and retention of the informa-tion. Not only are residents cheated oftheir education by being overworked,but so are the medical students,because residents supervise a largeportion of their clinical experience andprovide a significant percentage of theirteaching. Eventually, residents’depressed physical and mental statestrickles down to their personal and fam-ily life. Family relationships and qualityof life suffer secondary to resident men-tal and physical fatigue, depression, andresentment with work schedules.

The need for limitations on residentwork hours became apparent at anational level in 1984 when an 18-year-old female, Libby Zion, was admitted toCornell Medical Center and died shortlyafter admission to an inpatient unitallegedly due to negligence by over-worked and fatigued residents. Therewere numerous complaints regardingthe care she received, primarily by resi-dents, which precipitated a review bythe New York County grand jury. It wasdetermined that "the number of hoursthat interns and residents were requiredto work was counterproductive to pro-viding quality medical care." As a result,an Ad Hoc Advisory Committee wasestablished which adopted regulationsto protect patient welfare and safety. In1987, New York became the only statewith regulations mandating work hourlimits on residents. However, follow-upinvestigations in 1997 indicated wide-spread noncompliance with residentregulations, noting that 37% of all resi-dents exceeded 85 hours per week,20% exceeded 95 hours per week and60% of surgical residents exceeded 95hours per week.

As a result of similar situationsnationwide, the ACGME within the pastdecade created standards to be fol-lowed by voluntary compliance. Theyunfortunately have also been ineffective.In fact more than 10% of residency pro-grams surveyed by ACGME in 1999 vio-lated work hour compliance standards.Citations for these violations were infre-quent and removal of accreditation forrepeat offenders has yet to occur. Tohelp enforce decent working conditionsfor residents, the American MedicalStudent Association (AMSA), in May of

2001, petitioned OSHA to limit residentwork hours. The proposal included thefollowing highlights:

1. Limit work hours to 80 hour workweek

2. Limit shifts to 24 hour maximumconsecutive hours

3. Limit on call shifts to every thirdnight

4. Require a minimum of 10 hoursoff between shifts and

5. Require at least one 24 hour offduty period per week

OSHA declined to intervene. AMSAhas responded by beginning to gathersupport for legislation in favor of limita-tions on resident work hours.

But are federal mandates what EMphysicians really want and need? Doesthe ACGME need more empowermentto enforce voluntary compliance andwield the punishment of removingaccreditation or levying fines? The U.S.federal government already regulatesand places stipulations on the amountof hours worked and the amount ofsleep required for truck drivers and air-line pilots so that the general public isnot placed in harms way. Studies inthese populations have clearly demon-strated that there is impairment afterlong hours of work without sleep. Sowhy should a physician be put in a posi-tion to place their patients or themselvesin jeopardy because of prolonged workhours?

Granted, there are several inherentproblems with the governmental imposi-tion of resident work hours and whatduties and activities should be includedin the standards. The particulars areprobably best left to be decided by amulti-partisan panel of experts consist-ing of residents, faculty, and departmentheads, all of whom have different goals,needs, and expectations. Standardsdeveloped must include and apply to allforms of academic and clinical duties.This includes shift work, call, confer-ences, and moonlighting.

Ongoing research in the field ofphysician impairment secondary tosleep deprivation is in the preliminarystages. In October 2001 the AMA andthe American Academy of SleepMedicine will hold a conference to dis-cuss "the possible link between sleepdeprivation, physician performance andmedical errors." They will also be devel-oping guidelines "to alleviate the nega-

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tive impact resident work hours may have on patient safety,resident education and lifestyle issues." At the same timeCongress is delving into the relationship between sleep depri-vation and medical errors after last year’s Institute of Medicinereport.

The issue of resident work hours is a complex problem withno simple solutions. The medical community, including SAEM,needs to band together so that physicians are making the poli-cies regarding physicians, not the government. It is in thepatients’ and physicians’ best interest to have a multi-partisanpanel of experts who will work to develop effective residentwork hour guidelines to ensure the continuity of care forpatients and an effective educational environment for resi-dents. More importantly, it is the enforcement of these guide-lines that will make more caring and competent physicians.

Resident Work Hours (Continued)

Tales . . . . . . Jolly Ole Man and Eight Tiny Reindeer Marcus Martin, MDSAEM PresidentUniversity of Virginia

This is another tale from the crib (home). You may want toread this before your kids do.

A family tradition has been to attend Christmas Eve serv-ice, come home and enjoy each other's company and go tosleep to wait for Santa Claus to make his visit. One earlyChristmas morning I went downstairs to check to make sureSanta had left everything in good shape and there was no fur-ther work to be done. Sometimes Santa will leave a bike,stereo set, dollhouse, or some other toy under the tree withoutcompletely assembling them. As I proceeded to check thingsout, not a creature was stirring, not even a mouse! While look-ing around to make sure everything was properly assembled Iheard a noise. I quickly ran up the stairs and looked outside.There was a cloud passing over the moon and a vague silhou-ette of a sled, eight tiny reindeer and an obese bearded per-son on a sleigh. I ran and got my video camera and recordedthe whole thing. I came back in and looked around for someevidence, went into the kitchen and found some broken cook-ies and a partially consumed glass of milk on the table. I wascareful on Christmas Eve night not to make a fire in the fire-place in case Santa elected to come down the chimney. Inoticed the fireplace screen had been moved to the side, so Iassumed Santa actually came down the chimney. I went backdownstairs to check on the tree and toys and suddenly heard

someone coming. Not knowing whether Santa had returned orwhether my kids had gotten up early, I quickly ran into the util-ity room and hid. My kids were coming down the steps. Nowwhat! There was only one way out of the utility room and it leddirectly to the family room where the kids were waiting. WhenI came out of the utility room my kids looked at me and said"Dad, what are you doing?" I said, "I thought it was ok tocome down and see what Santa had left and when I heardfootsteps I thought he had returned. So I hid in the utilityroom." I spent a few minutes with the kids playing with theirtoys. Since it was around 5:00 am, I went back upstairs andwent to bed. What a night! Thank goodness I did not have towork in the ED that day. After about 2 hours of sleep, and atthe coaxing of my kids, I got up from the bed and played withthe toys, enjoyed a nice breakfast cooked by mom and gavethanks and praise for the true meaning of Christmas.

I hope you have had Christmas experiences as vivid asmine. Happy Holidays to you and your immediate and extend-ed families for this upcoming Thanksgiving and Christmas. Iam also looking forward to the upcoming New Year. Don’t for-get to get your SAEM abstract in before the deadline ofJanuary 8, 2002, 3:00 pm Eastern Time. On Brian, on Roger,on Don and Carey, on Judd, on Debra, on Glenn and Jim, onSue and Mary Ann too. Well, I guess that makes me Rudolph!But who is Santa?

There is probably a little Santa in each of you.

Thanks SAEM for a great 2001!

AEM Call for Papers“Best Practices”

The Council of Emergency Medicine ResidencyDirectors (CORD) is sponsoring a ConsensusConference to present and discuss “best practice”models in emergency medicine, residency education.The conference will be held March 2-4, 2002 inWashington, DC. This conference will highlightmodels to incorporate the six new ACGME corecompetencies into educational programs, and willalso explore “best practices” in other important areasof the emergency medicine curriculum. In addition,topics related to evaluation and assessment of theeffectiveness of educational curricula will bediscussed.

Manuscripts relevant to these topics are beingsolicited for consideration of publication in AcademicEmergency Medicine. The deadline for receipt ofmanuscripts is December 15, 2001. Instructions forauthors appear on the website atwww.saem.org/inform/journal.htm. Send manuscripts,including one blinded copy, one original copy, and anauthor copyright and disclosure form to AEM(preferably electronic to aem@saem.org). Be sure tospecify that the manuscript is for the Best Practicesissue. Any questions can be directed to MichelleBiros, MD, at biros001@maroon.tc.umn.edu.

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ABEM Philosophy of Combined Training Programs and Review Process

At the 2001 SAEM Annual Meeting in Atlanta, the ABEM report included a discussion of combined training programs inEmergency Medicine and other primary specialties. This information came out of the ABEM Board meeting on February 2, 2001.Currently, the Board has approved Emergency Medicine combined training programs with Pediatrics, Internal Medicine, andInternal Medicine/Critical Care Medicine. It clarified that proposals for new combined training options should support an estab-lished career path that a significant number of individuals have already pursued, rather than seek to establish a new career pathto attract individuals. The Board identified several areas of information that are important to have in place when considering aproposed combined training program. Institutions interested in starting a combined training program should contact ABEM.

Information Required For Proposed Combined Training Programs1. What is the name of the specialty to be combined with EM training?2. What is the origin of the request to consider a combined training program?3. What are the basic objectives of a combined training program in EM and the other specialty?4. How would a combined training option in EM and the other specialty improve patient care?5. How many institutions have accredited programs in both specialties?6. Include a written commitment from at least six training programs that support the proposed com-

bined program.7. What is the anticipated career path of graduates of such a combined program? In addition,

would there be a reasonable demand for the graduates of such a program?8. How many practicing physicians are currently dual-boarded in EM and the other specialty?9. Include statements from physicians who have pursued this career path.10. Include a template of a proposed curriculum clearly showing and describing the overlap that is

possible between the two specialties.11. How would the combined program be funded?12. How would diplomates certified through the combined program recertify or maintain certification

in both specialty areas?13. Include a letter of endorsement from the director or other appropriate individual of the residen-

cy program of the specialty with which the combined program would be developed.14. Has there been contact with the other specialty board? If so, what was the response?

Scholarly Sabbatical Grant Recipient Reports (Continued)derful opportunity to grow and learn,and perhaps make future contributions.I am not fellowship trained and graduat-ed residency without any particularresearch expertise. Nevertheless, theaward allowed for important growth.

One blessing that evolves from the rela-tive youth of our specialty, is the fact thatconsiderable funding is available to evenvery inexperienced faculty such asmyself. Not all of us have completed orcontemplated fellowship training. While

not a substitute, this grant makes possi-ble training that for me would have beenvery difficult to obtain otherwise.

handy feature is a direct link to theauthor’s email if you have questions orcomments regarding the article youhave read.

If you choose the search commandin the archives section, again one cansearch by citation, author or key wordsand across multiple journals. If theauthor you are looking for is not avail-able on AEM, it allows you with the clickof the button to try to search anotherjournal available from a drop down list.Another nice advantage of this searchengine is it allows you to search for key-words anywhere in the article instead ofthe only the abstract and title which ismore customary.

When you pull up the full text of thearticle, you are able to quickly move

through the main sub-headings with theclick of a mouse. No more scrolling untilyou get vertigo. The tables and figurescan be viewed either within a small win-dow, blown up in a separate window, orat an even higher resolution (36K).

One of the most useful features isthe ability to directly access the abstractor in some cases the full text of the liter-ature referenced simply by clicking onthe blue highlighted text at the end ofthe reference. If “full text” is displayed,there are links to other Highwire journalsites that share articles between sub-scribers. AEM plans to expand theaccess to full text by subscribing to aconsortium of over 70 publications in3800 other journals. This feature will beparticularly helpful to those subscribers

without institutional affiliation or whoseinstitutions do not subscribe to a largenumber of journals.

In summary, the AEM website is anextremely resourceful tool that willgreatly increase your efficiency, savingyou searching time both electronic andbipedal. So please, if you have not uti-lized it already, it behooves you toaccess your AEM journal account atwww.aemj.org. Once you haveaccessed this site, bookmark it,because I guarantee that you will utilizeit repeatedly. If you have any feedbackabout the site, send it by clicking thefeedback button, as it is our wish tomake this site as easy as possible toaccess.

Academic Emergency Medicine Website (Continued)

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September 11th (Continued)

Kevin Chason, DO, Co-Director, Division of EMS and DisasterPreparedness, Department of Emergency Medicine, MountSinai School of Medicine

When notified of the disaster at the World Trade Center(WTC) at the Mount Sinai Hospital we immediately activatedour disaster plan. We were able to clear out the EmergencyDepartment and admit the patients already waiting for beds inone hour. We identified and organized the triage and treatmentteams and operating rooms and ICU beds were readied. Weestablished a staffing pool and received O negative blood,antibiotics and prepared for trauma and burn injuries. Then wewaited for patients to arrive, but few came. We treated 20 minortrauma patients during the first 8 hours and then over the next3 days waited to receive patients as they were extricated fromthe debris. We were overwhelmed with feelings of sorrow andfrustration at our inability to provide meaningful medical assis-tance. A natural response that must be addressed in disasterplanning with timely debriefing.

Our disaster operations were thus never really challengedby a large numbers of victims, but we were ready. There was acommunications breakdown between the City’s disaster oper-ations and the hospitals so we were in the dark as to what wascoming our way or if we were still needed or could stand downfrom our deployment. We received much of our informationearly on by Internet and television broadcast. The City of NewYork’s Emergency Operations Center was in the WTC so itscoordinating and communication functions were lost for a peri-od of several hours while an alternate site was being set up.Our phone system was very unreliable and using radios at keyposts was very helpful. Because of the lack of communicationswe were also uncertain of the decontamination and contain-ment needs of our patients. Our external decontaminationshower was deployed, but never put into action. While thereare reports at other sites, patients covered in dust and debriswere decontaminated.

The problem of overcrowding and the lack of inpatient bedsare facts of life for us at Mount Sinai. However when the dis-aster plan was activated, suddenly 160 inpatients could be dis-charged and the patients in the ED waiting for beds left theDepartment in a very short period of time. Similar scenarioswere played out in a number of our neighboring hospitals aswell. This phenomenon provides a very important window intothe problems of length of stay, ED overcrowding and theadmission and discharge processes in our institutions.

Neill Oster, MD, Co-director of the Division of EMS/DisasterPreparedness, Mount Sinai Department of EmergencyMedicine

Our Departmental Disaster plan at Elmhurst City Hospitalwas rapidly deployed and we unfortunately did not receive sig-nificant numbers of casualties. As I am involved in the Mayor’sAntiterrorism Task Force and the Office of EmergencyManagement, I was able to participate and learned moreabout the response and the issues at ground zero. The humancarnage that occurred and the massiveness of the destructionwere very difficult to comprehend, let alone respond to in anorganized way. However the dedication and selflessness of theuniformed services and the volunteers were monumental andtheir efforts truly mitigated the loss of life.

While an official critique of the response is yet to come,there are a number of observations that I and others have

made that will be helpful in future planning. The decision tolocate the emergency management command post at theWTC was clearly an unfortunate one. What is needed is asecure and safe low profile location. There was no organizedbackup incident command center and this function will have tobe added to the City’s plan. The initial wave of casualties wereall dispersed to the three closest hospitals which were tran-siently overwhelmed. Had there been a second wave ofpatients there could have been a delay in management ofunstable patients. The transportation decisions were ham-pered by the lack of onsite command and communicationssystems. There was a massive turnout of volunteers. Crowdcontrol, initial supervision, and organization of the volunteerrescuers, as well as their safety were unanticipated problems.There were inadequate supplies of dust masks and eye pro-tection during the early phase of response of the rescuers. Themedia descended on the perimeter of the site and intervieweda number of the physicians and volunteers as they exited theperimeter. There were a few interviewees who transmittederroneous information. Thus, systems of crowd control andmedia access and control will have to be reconfigured. Finallyin approaching multi-casualty situations in high rise buildingsthere will have to be a rethinking of the locations of the patientcollection stations, as well as the location of the perimeterbeyond which access to the site by men and equipment has tobe limited and controlled.

James Pruden, MD, Director of Emergency Services, St.Joseph’s Hospital, Paterson, NJ, Assistant Clinical Professor,Emergency Medicine, Mount Sinai School Medicine

In the first few hours after the attacks, there were scores ofphysicians and nurses that went to the area of the fallen build-ings to offer their services. In light of the devastating impactthis event had on the leadership in the Fire Department of NewYork (FDNY), as well as the loss of significant communicationcapabilities (cell phone broadcasting sites and satellite siteswere located at the top of the World Trade Center), effectiveradio and telephone communication was temporarily lost. Itwas impossible to learn if we were needed or specifically whatwas needed.

As an emergency physician, trained in Urban Search andRescue, I too responded directly to the area, thereby violatingone of the standard principles of this kind of work. That princi-ple is to "avoid freelancing". Freelancing is acting independ-ently outside of an organizational structure. Freelancing alsomakes it hard to maximize rescuer safety, working withoutsome kind of reporting structure or buddy system and a com-mand structure. Nonetheless, that seemed to be what the sit-uation called for at the time, and I am sure that others felt thatway as well. I did make it my goal to try to network with otherresources in the area. With the help of an Army RangerCaptain, and some volunteer Office of Emergency MedicineServices people, we established a triage area. The goal was todirect the walking wounded further away from the area ofongoing danger. and to do some initial sorting of others thatcame through. After establishing a process and leavingsomeone else in charge, another EMS worker and I sought toidentify and quantify available medical resources, and estab-lish ambulance transport points. Much of those early hours,was spent also spent in attempting to make connections thatmaximized our joint functions, and then letting other groupsknow what was available and where.

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September 11th (Continued)

There was, as it turned out, a superabun-dance of physicians at the scene. Most ofthem were not trained in EmergencyMedicine or prehospital care. There werecertainly issues of training, liability, safetyand adequate personal protection.Because we did not know the extent ofthe casualties we would be triaging andmanaging we made the decision to findfunctions for these uninitiated providersand keep them at the site. Besides, youcould not have gotten most of those peo-ple away from that site with a stick ofdynamite. Their fervent need to help, toparticipate, to DO SOMETHING was thatstrong.

Ultimately, there were MASH capabili-ties established at Chelsea pier, (about1.5 miles from ground zero) there were 15to 20 physicians at or near the new triagearea. We relocated our original triagearea to this site when it became clear thatBuilding Seven near our post was goingto go down, and it was also becomingclear that there was not going to be a sud-den influx of overwhelming numbers ofpatients in a second wave of casualties.

On the positive side, our actionsseemed to coordinate the availableresources placing the volunteers into anoperational team that approximated apatient triage and collection station.Triage was ultimately set up in close prox-imity to transport capabilities and peoplein the area were informed as to where themedical resources were being concen-trated.

We did not sustain significant injuriesamong the rescuers in my group but thiswas an ever-present danger. I was absentfor the first few hours during the mobiliza-tion of the New Jersey EmergencyResponse Task Force in which I play aleadership role. However, they seemed toperform splendidly in my absence. I amstill ruminating about the appropriatenessof my actions as a freelance organizer atthe site of the disaster.

And so it goes, our world turned upside down on September 11 and we areruminatively replaying the event in ourminds. We have learned a number ofvery painful lessons that will change howwe prepare and respond to disaster andother multi-casualty events should we becalled upon to serve once again. As wecontinue to work on our response capa-bilities and operational readiness ourimmediate response as emergencyphysicians is to redouble our standingcommitments to our families patients,trainees and country.

Ethics Consultation Service Every day emergency physicians

are faced with countless ethical dilem-mas. In our practice, our teaching, ourresearch and our administrativeduties, we make choices based notonly on our knowledge but also on ourpersonal beliefs and value systems.For the most part, these decisions aremade in typical emergency medicinestyle--- we think, we decide, we act,and we move on. We feel confidentthat we have acted appropriately,based on a reasoned assessment ofthe circumstances and the strengthsof our convictions. We act in goodfaith, and hope that we have actedwisely and justly.

Occasionally, an ethical issue aris-es that is outside our world view orconsideration, or a situation confrontsus that makes us uncomfortable. Wemay lack the knowledge that we needto make a reasonable choice, we maybe faced with something totally out ofour experience, or we feel at a lossbecause we cannot determine thepossible options. We may witness anethically questionable act, mayobserve unprofessional and possiblyharmful actions, may disagree aboutthe correctness of another’s decision,or may feel we ourselves are beingsubjected to exploitation, abuse, orother unethical behavior. Such situa-tions are frightening; it is difficult todistinguish reality from perception, toknow who can be approached foradvice, or where resources can befound to assist in developing anappropriate response.

Some institutions have committeesor other authoritative bodies designedto examine grievances, allegations ofscientific misconduct or specific ethi-cal dilemmas in clinical practice.

The advice of these groups, how-ever, may have limited applicability toemergency medicine; they may notinclude emergency physicians, or

have the expertise to relate to theunique aspects of the ethics of emer-gency medicine. In addition, thesegroups are charged with developing aresponse to a particular crisis that hasarisen locally. They are goal directedand not necessarily able to provide athoughtful method to educate beyondthe concrete response to the problemat hand.

For these reasons, the SAEMBoard charged the Ethics Committeeto develop an Ethics ConsultationService. As the title implies, theEthics Consultation Service is avail-able to assist SAEM members withtheir questions concerning ethicalissues or decisions they must makeduring the course of their clinical, aca-demic or administrative responsibili-ties.

Opinions from the EthicsConsultation Service will be offered toSAEM members in a timely manner;requests from nonmembers will beconsidered on a case by case basis.The opinions rendered are not meantto be part of an ‘appeal process.’ Thisservice is offered to SAEM memberswho may need advice or assistancewhen faced with a difficult ethicaldecision.

All communications with the EthicsConsultation Service will be anony-mous and confidential. However,because many ethical issues con-fronting practicing emergency physi-cians are universal in their scope, andothers may learn from the issue pre-sented, we hope to develop a series ofarticles for publication for the Society,assuming that confidentiality can bemaintained.

All requests, inquires, or correspondence should be directed tothe Ethics Consultation Service at SAEM, 901 North WashingtonAvenue, Lansing, MI 48906 orsaem@saem.org.

Password Required to Receive AEM OnlineSAEM members must now use a password to access their online subscrip-

tion to Academic Emergency Medicine. All SAEM members are entitled toreceive a free subscription of both the print copy and online version of AEM.

To activate your subscription go to the website: www.aemj.org, Click on thesubscriptions button. Click on the link “activate your member subscription.”Enter your membership number (which is printed above your name on the mail-ing label of this Newsletter) and click the submit button. You will then be askedto select a user name and password. If you need assistance or do not have amember number, send an email to saem@saem.org or call 517-485-5484.

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President’s Message (Continued)prayers are with you all and with our fel-low emergency workers in these areaswho are trying their utmost to cope withthis situation." V. Anantharaman

"It was a difficult day for all of us andI fear the worse is yet to come. All ourfaculty, residents and staff are safe asare myself and family but we have sev-eral individuals in our department whohave family members who are still miss-ing. And all of us have lost friendsamongst the hundreds of emergencypersonnel who were killed at the scenewhen the World Trade Center collapsed.I am proud of the way emergency physi-cians around the city met the challengeof preparing for thousands of casualties.Unfortunately, very few victims survivedto have need of our care. It is likely thatthose thousands are buried in the rub-ble and the agonizing process of return-ing their bodies would take months.Thank you for your concern and sup-port. We will continue to draw comfort inthem in days ahead." LynneRichardson

"It is very hard for us to see youworking hard in this treachery attack,instead of being there and helping you.I wish this will be the last violence inyour country and all over the world. Weall are ready for any kind of support tohelp you. Our hearts and prayers arewith you especially the emergency staffwho are lost in the wreckage of build-ings and all American people." SedatYanturali (Turkey)

In this Newsletter, Dr. SheldonJacobson and others provide anaccount of September 11, 2001.Although we have experienced greatchange in our lives with the indelibleevents of September 11 and the realityof bioterrorism, we must continue ourdaily lives and Societal activities withfervency. I am happy to report to theSAEM membership on the activities ofour committees and task forces at thistime.

The SAEM committees and taskforces have made steady progresstowards accomplishing their objectives.The Emergency Care CenterCategorization Committee has stream-lined the application process and con-tinues to work to improve upon theapplication and make it easier for ourmembers to apply. The EthicsCommittee has worked on ethical casestudies and submitted course proposalsfor the annual meeting. The Ethics

Committee is also developing a teach-ing module for emergency medicineresidency programs and developedguidelines for filming of patients in aca-demic emergency departments. TheBoard of Directors has also developed aposition statement on filming of patientsin the ED. The Faculty DevelopmentCommittee has developed the facultydevelopment section of the SAEM web-site and has made tremendousprogress towards the completion of theFaculty Development AcademicHandbook. The Graduate MedicalEducation Committee is developing afellowship catalogue and developed askeleton curriculum of a teaching mod-ule for residents interested in an aca-demic career. The resident section ofthe website has been revised and addi-tional articles have been posted for res-idents interested in an academic career.

The Grants Committee has beencoordinating the application processand will be recommending recipients tothe Board for the medical student inter-est group, scholarly sabbatical,research training, neuroscience fellow-ship, EMF/SAEM innovations in emer-gency medicine education, EMSresearch fellowship, EMF/SAEM med-ical student, and institutional researchtraining grants. We established theinstitutional research training grant thisyear and expanded funding for theresearch training grant. These additionswill provide more opportunities for mem-bers of our organization to achieve nec-essary research skills and further posi-tion SAEM and members to advanceour mission of improving patient carethrough research and education.

The National Affairs Task Force hasbeen active in representing SAEM atthe AAMC and AMA and has submittedperiodic reports, positions papers andarticles. In collaboration with theAssociation of Academic Chairs, theNational Affairs Task Force has sched-uled a conference at the AAMC meetingin Washington, DC on November 4,2001. At that meeting, a report on theSafety Net Consensus Conference heldat SAEM in May 2001 will be deliveredby Lynne Richardson and Jim Gordonand AAMC staffer Richard Knapp is toattend. The NATF wrote a letter of sup-port for the Medicare Education andRegulatory Fairness Act (MERFA),which was sent to Congress (the text ofthe letter is in this Newsletter). The bill(S452) provides added protection to

physicians undergoing an audit, estab-lishes an education program for caregivers to help them with paperwork andregulations and streamlines some regu-lations reducing the amount of timespent on paperwork. SAEM expressedconcern for the amount of time emer-gency physicians spend documentingon charts which takes time away frompatient care.

The NATF also wrote a letter to CMSin regards to the Medicare program’s 5-year review of RVU’s stating SAEM’sconcerns about uncompensated carefor patients who are "admitted andboarded in the ED." SAEM asked for acritical analysis of ED boarding ofpatients who are kept in the emergencydepartment while waiting for an inpa-tient bed. Jill Grant the resident mem-ber of the NATF wrote an article in thisNewsletter on resident work hours.

The Patient Safety Task Force is inthe process of developing a teachingmodule on patient safety. Didactic pro-posals have been submitted for theAnnual Meeting. A Newsletter article onresearch opportunities related to patientsafety is in progress. Members of thePatient Safety Task Force were able toobtain multi-site funding through theNational Patient Safety Foundation.

The Program Committee has beenworking steadily on developing andcoordinating the 2002 Annual Meeting.The Program Committee is on schedulewith review of didactic proposals ofwhich there were 94 submitted this year.They are assigning abstract reviewersand generally progressing well. IEMEexhibits will continue with a separateapplication progress from the abstractsubmission.

The Public Health Task Force hasbeen developing a teaching moduledirected towards residents to explainHP 2010 and its objectives. PublicHealth Task Force members have initiat-ed several projects of direct relevance toHP 2010 objectives. Some projectsunder development include ED over-crowding, diabetes screening, falls inthe elderly, ED alert network, alcoholscreening and smoking sensation.Project specific action plans will be sub-mitted to the Board for approval.

The Research Committee has sub-mitted didactic proposals including ses-sions focusing on NIH and othersources of federal funding. TheResearch Committee is also well on itsway in accomplishing other objectives

(continued on next page)

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President’s Message (Continued)such as SAEM newsletter articles profil-ing EM researchers, development of aprogram by which the ResearchCommittee can provide mentorship forjunior researchers and identifyingorganizations that SAEM can interactwith and exchange information.

The Salary Survey Task Force hasdisseminated the salary survey andcompleted surveys are steadily return-ing. The Undergraduate EducationCommittee has developed the virtualadvisor program, which has alreadybecome successful. The medical stu-dent section of the website has beenrevised and enhances SAEM’s visibilityto medical students. With outstandingcooperation of SAEM staff, computerconsultants and members of the sub-committee, the actual web page wasadded to the SAEM home page in timeto be used for the 2001-2002 applica-tion cycle. The AAMC accepted the vir-tual advisor project as an exhibit for theNovember AAMC meeting and was writ-ten up in the September issue of theAAMC newsletter in the "web watchsection". The Undergraduate EducationCommittee organized various slide pre-sentations that should prove to be use-ful to faculty who are conducting meet-ings for medical students about the spe-cialty of emergency medicine. A com-plete power point presentation on topicssuch as how to structure the 4th yearmedical school, how to apply to resi-dency, and career options in emergencymedicine is available on the SAEM webpage. For the future, the UndergraduateCommittee will work to develop a ques-tion and answer bank (shelf exam formedical student evaluation).

The Under Represented MemberResearch Mentoring Task Force hasprogressed well under the leadership ofone of our new Board members, Glenn

Hamilton. The focus of this task force isto provide mentoring to under repre-sented members of SAEM and addresscultural competency issues, to developa teaching module on cultural compe-tency and to develop a monograph toencourage under represented minoritymedical students to consider emer-gency medicine as a specialty. Morethan 20 sites are involved and focusgroups are being developed to ultimate-ly serve as a basis for the developmentof the medical student monograph.Development of a teaching module withmany cultural competency cases shouldprove to be valuable to emergency med-icine.

The new PR Committee was formedthis year and initiated an annualannouncement of the incoming SAEMpresident with a brief overview of objec-tives that were sent to the president’shometown paper, institution and severalnational papers and magazines for pub-lication. SAEM and the presidentbecome better known through thisprocess. The PR Committee met inChicago and discussed additional pub-lic relation efforts including advertisingthe annual meeting to other organiza-tions.

During the SAEM Board meeting inChicago in October, the Board voted toraise the dues for 2002. The dues havenot changed since 1995. Consideringbudgetary projections for SAEM, it isevident that a dues increase is needed.It is important to maintain financial sta-bility to continue our mission and bene-fits. In this edition of the SAEMNewsletter, reasons for dues increaseare further elaborated.

I appointed several Board membersto a subcommittee on SAEM ResearchFunds and Finances. It is crucial thatwe further develop the SAEM Research

Fund and secure SAEM’s future finan-cially. This Board subcommittee isworking on an SAEM Research Fundstrategic plan that includes ways toenhance finances available for currentand future training grants, fellowshipsand sabbaticals. At the Board’s longrange planning meeting in March 2002,we will consider projections for thefuture including the SAEM ResearchFund.

As we go forward, the NominatingCommittee will be considering nomina-tions for Leadership, AcademicExcellence and Young InvestigatorsAwards and developing a slate of candi-dates for the elected positions.

This past year, SAEM held for thefirst time a mail ballot election that wasvery successful. Your response by vot-ing in the 2002 mail ballot will be crucialin setting the stage for SAEM for yearsto come. We look forward to your par-ticipation in the election process. Welook forward to your submission ofabstracts for the Annual Meeting and welook forward to seeing you in St. Louis inMay 2002.

All in all, I feel that SAEM’s progressthis year has been significant. We areliving in times like no other and I amprivileged to be an SAEM member andthe current president. Regarding thesecond half of this year’s presidency, Ifeel confident that we will continue theprogress and stay ahead of the game aswe have done in the first half.

I wish you, your family and friends ablessed holiday season and I look for-ward to communicating with you againthe first of the New Year.

Marcus L. Martin, MDUniversity of Virginia

The Top 5 Most-Frequently-Read Contents of AEMDuring the Month of September 2001

Most-read rankings are recalculated at the beginning of the month. Rankings are based on hits received by articlesarchived on AEMJ.org.

Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency DepartmentAcad Emerg Med Sep 01, 2001 8: 873-879. (In "CLINICAL INVESTIGATIONS")

Bench to Bedside: Resuscitation from Prolonged Ventricular FibrillationAcad Emerg Med Sep 01, 2001 8: 909-924. (In "SPECIAL CONTRIBUTIONS")

Utility of an Initial D-dimer Assay in Screening for Traumatic or Spontaneous Intracranial HemorrhageAcad Emerg Med Sep 01, 2001 8: 859-865. (In "BASIC INVESTIGATIONS")

Epidemiology of Thoracolumbar Spine Injury in Blunt TraumaAcad Emerg Med Sep 01, 2001 8: 866-872. (In "CLINICAL INVESTIGATIONS")

Are Emergency Department Patients at Risk for Herb-Drug Interactions?Acad Emerg Med Sep 01, 2001 8: 932-934. (In "BRIEF REPORTS")

11112222333344445555

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FACULTY POSITIONSALBANY MEDICAL COLLEGE – CHAIR POSITION: The Albany MedicalCollege Department of Emergency Medicine is seeking a residencytrained, Board Certified emergency physician for the position ofChairperson. The Chair’s responsibilities will include overseeing clinicaloperations, the research program, and the educational missions of theDepartment. The Albany Medical College, Department of EmergencyMedicine, the first academic department in New York State, evaluates andtreats 65,000 patients annually and serves as the primary teaching site fora fully accredited emergency medicine residency program. TheDepartment faculty provide medical direction for the hospital based airmedical program, ground EMS agencies, and a variety of advanced lifesupport training programs. The Department has a history of excellence inpatient care, academic productivity and administrative leadership andseeks an individual who will enhance these core missions. The AlbanyMedical College is an equal opportunity/affirmative action employer.Send CV to Kevin Roberts, MD, Chairman, Emergency Medicine SearchCommittee, Albany Medical College, MC-131, 47 New Scotland Avenue,Albany, NY 12208, 518-262-4305; Fax 518-262-4736 orrobertk@mail.amc.edu.

ANN ARBOR, MICHIGAN – FACULTY/CLINICAL STAFF and RESEARCHDIRECTOR (ACADEMIC SETTING): Seeking BC/BP EM physicians to joinSt. Joseph Mercy Hospital. Clinical research experience required forDirectorship. Level II Trauma Center with on-site Medflight air ambulanceservice that sees 92,000 patients annually between the ED, adult andpediatric ambulatory care centers, and chest pain observation unit.Approved EM Residency program sponsored by the hospital and U of MMedical Center. Employed positions offer excellent remuneration, facultystipend, paid malpractice, relocation allowance, cafeteria-style benefits,401(K), long term disability, flexible scheduling and more. Directorposition offers dedicated protected time. Contact Nancy Ely at 800-466-3764, ext. 337; nely@epmgpc.com; or visit us at EPMGPC.com

INDIANA UNIVERSITY SCHOOL OF MEDICINE: Department ofEmergency Medicine is recruiting clinician teachers to provide care at thepublic hospital emergency department located on the medical centercampus. Wishard Hospital is a Level I Trauma Center, base for one of thecountry’s busiest pre-hospital emergency transport services, and regionalburn center. The ED recorded 105,000 visits in 2000. Wishardcomplements Methodist in providing clinical experiences for IUSM EMresidents. Enthusiasm for medical education, facilitation of clinicalresearch, and excitement for patient care in a busy public hospital ED areexpectations. Residency training, certification in EM are required. Rankand tenure status are dependent upon interests and qualifications. Applyto Jamie Jones MD (jhjones@iupui.edu) or Rolly McGrath, MD(rmcgrath@iupui.edu), FAX (317) 656-4216. IU is an EEO/AA Employer,M/F/D.

JACKSON MEMORIAL HOSPITAL, MIAMI, FL – ASSOCIATE MEDICALDIRECTOR EMERGENCY CARE CENTER: Main teaching hospital for theUniversity of Miami School of Medicine. Hospital has level one TraumaCenter, >100,000 patients per visit per year. We are looking for acandidate with administrative and education experience. Minimumrequirement: EM Boarded and 4 years of experience. EM/IM boardscertified a plus. Excellent salary & benefits. Ample protected time forteaching and administrative duties. Florida license required. Contact:Abdul Memon, MD, Medical Director, Emergency Care Services, office:(305) 585-6913, email: Amemon@med.miami.edu.

OHIO STATE UNIVERSITY: Assistant/Associate or Full Professor.Established residency training program. Level 1 Trauma center. Nationallyrecognized research program. Clinical opportunities at OSU MedicalCenter and affiliated hospitals. Send curriculum vitae to: Douglas A.Rund, MD, Professor and Chairman, Department of Emergency Medicine,The Ohio State University, 016 Health Sciences Library, 376 W. 10thAvenue, Columbus OH 43210 or call (614) 293-8176. AffirmativeAction/Equal Opportunity Employer.

OREGON: The Oregon Health Sciences University Department ofEmergency Medicine is conducting an ongoing recruitment of talentedentry-level clinical faculty members at the assistant professor level.Preference is given to those with fellowship training, experience incollaborative clinical research, and writing skills, Please submit a letter ofinterest, CV, and the names and phone numbers of three references to:Jerris Hedges, MD, MS, Professor & Chair, OHSU Department ofEmergency Medicine, 3181 SW Sam. Jackson Park Road, UHN-52,Portland OR 97201-3098.

PENNSYLVANIA: We’re adding two positions to assure triple coverage –one available now and one this summer. Seeking BC/BE EM-trained

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

RESIDENT EMS COORDINATOR

The Division of Emergency Medicine at DukeUniversity Medical Center is working to develop

an Emergency Medicine Residency Program. We are currently seeking a faculty member witha strong interest in EMS. This position offers

opportunities for community EMS involvement,clinical practice in the ED, teaching, and

research. Residency training and BC in EM required. Duke University Medical Center

Emergency Department is a Level I TraumaCenter in Durham, North Carolina, withan annual volume of 65,000 patient visits.

Competitive salary and benefits.Faculty with EMS fellowship training are

especially invited to apply.

Please contact:

Kathleen J. Clem, MD, FACEPChief, Division of Emergency Medicine

DUMC 3096, Durham, NC 27710email: clem002@mc.duke.edu

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physicians to join cohesive faculty of 30 BC physicians evaluating100,000 patients at 700-bed Lehigh Valley Hospital’s three sites. LVH isacademic, tertiary hospital with EM Residency, Level I trauma, 9-bed BurnCenter and 10 residency programs. Member of the prestigious Council ofTeaching Hospitals (COTH). Faculty appointment at Penn State/Hershey.Opportunity for resident teaching and clinical research. Allentown hasgreat public schools, safe neighborhoods, moderate cost of living, 10colleges and universities, and is 60 miles North of Philadelphia and 80miles West of Manhattan. Email CV c/o Michael Weinstock MD, ChairEM, to carol.voorhees@lvh.com. Fax (610) 402-7014. Phone (610) 402-7008.

UCLA EMERGENCY MEDICINE CENTER: Announces the availability of afellowship in emergency medicine for graduates of EM residencyprogram. The two year research fellowship is integrated with the RobertWood Johnson Clinical Scholars Program and the UCLA School of PublicHealth. Candidates may obtain with an MPH or PhD degree. ContactLarry J. Baraff, MD, UCLA Emergency Medicine Center, 924 WestwoodBlvd, Suite 300, Los Angeles, CA 90024-1777, or lbaraff@ucla.edu.

THE UNIVERSITY OF CALIFORNIA, DAVIS, SCHOOL OF MEDICINE:Recruiting for a full-time faculty at the Assistant, Associate or FullProfessor level, in the Division of Emergency Medicine and ClinicalToxicology. A residency training program in emergency medicine beganover 10 years ago and currently has 29 residents. The UCDMC EmergencyDepartment provides comprehensive emergency service as a Level ITrauma Center, as well as a paramedic base station and training center.Candidates for this position must be board certified or eligible inemergency medicine and be eligible for licensure in California. Openuntil filled, but no later than 1/31/02. For consideration, a letter outlininginterests and experience, and curriculum vitae should be sent to: RobertDerlet, MD, Chair, Emergency Medicine Search Committee #3053,University of California, Davis Medical Center, 2315 Stockton Blvd., PSSB2100, Sacramento, CA 95817. The University of California is anaffirmative action/equal opportunity employer.

UNIVERSITY OF MICHIGAN: The Department of Emergency Medicineat the University of Michigan is seeking a Residency Program Director forthe Emergency Medicine Residency Program. The residency program is ajoint program between the University of Michigan and St. Joseph MercyHospital both located in Ann Arbor. The residency program is a four-yearprogram with 56 approved residents. Candidates at the AssociateProfessor level (either clinical or tenure track) preferred. Excellent fringebenefit package. If interested, please send curriculum vitae to: William G.Barsan, MD, Professor and Chair, Department of Emergency Medicine,UMHS, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0303. TheUniversity of Michigan is an equal opportunity affirmative actionemployer.

UNIVERSITY OF NEBRASKA MEDICAL CENTER: Section of EmergencyMedicine, seeks an ABEM board eligible or -certified individual for a full-time academic position. This is an exceptional opportunity to be a part ofa young, dynamic group in an outstanding tertiary referral environment.Generous salary, benefits and CME. Respond in confidence to: Robert M.Muelleman, M.D., Professor, Director of Emergency Medicine, Universityof Nebraska Medical Center, 1150 UNMC, Omaha, NE 68198-1150.(402-559-6705) The University of Nebraska is an affirmative action/equalopportunity employer. Minorities and women are encouraged to apply.

UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL: 2 openings foreither full-time academically qualified Emergency Medicine, tenure-trackphysicians or for full-time clinical track physicians at the ClinicalInstructor or Clinical Assistant Professor level. Successful tenure-trackcandidates will be Board Certified/Board Prepared in EmergencyMedicine with an interest in clinical cardiology or neurosciencesresearch. Clinical track faculty are expected to do clinical work only.UNC Hospitals is a 665-bed Level I Trauma Center. The EmergencyDepartment sees upward of 40,000 high acuity patients per year, is activein regional EMS, ACLS/ATLS/BTLS education and has an aeromedicalservice. Send CV to Edward Jackem, MBA, Department of EmergencyMedicine, CB #7594, Chapel Hill, NC 27599-7594. (919) 966-5943. FAX(919) 966-3049. UNC is an Equal Opportunity/ADA Employer. Womenand minorities are encouraged to apply.

VANDERBILT UNIVERSITY: Research Position — The Department ofEmergency Medicine at Vanderbilt University is seeking a research-oriented faculty member for a tenure track position. This position will becustomized to meet a junior or senior level faculty member’s training andexperience. This exciting position is based in the Department ofEmergency Medicine in collaboration with The Vanderbilt Center forHealth Services Research. The individual to be recruited will have

Faculty Development FellowshipThe Wright State University School of Medicine, Department of

Emergency Medicine is pleased to announce the second year of its newFaculty Development Fellowship. Must have completed Emergency MedicineResidency and be Board Prepared. Starting dates are flexible. The Fellowshiphas an 18 hour / week clinical commitment at one of our several practicesites (30,000 to 95,000 patient visits.) There are planned instructionalsessions in didactic and clinical teaching, curriculum design, researchproject planning, grantsmanship, writing and publishing in the medicalliterature, use of media, administrative skills, international emergencymedicine and several other topics. Each segment is linked to the expertise ofa specific faculty members, combined with written materials. A portion ofthe program can be tailored to the needs and interests of each fellow. Stipendis $50,000 plus generous benefits and travel support. We are currentlyaccepting applications for 2002. Please include a CV, letter of interest andtwo letters of reference. If you have an interest in academic emergencymedicine and would enjoy a year of focused training in the skills necessaryto establish your career, contact:

Glenn C. Hamilton, MD, MSMDepartment of Emergency Medicine

3525 Southern Blvd., Kettering, OH 45429Phone: (937) 296-7839 • Fax: (937) 296-4287

email: glenn.hamilton@wright.edu

Consideration of applications begins September 15, 2001 and will continueuntil the positions are filled. Wright State University is an AAEO Employer.

We are increasing our faculty again! These are all newopenings. The Brody School of Medicine at East CarolinaUniversity has immediate openings available for emergencyphysicians at the rank of assistant professor or above,depending upon the candidate’s qualifications. Physiciansmust have emergency medicine residency training orABEM/AOBEM certification. The emergency medicineresidency program has been fully accredited since 1982.Many faculty are extensively involved in state and nationalactivities. Pitt County Memorial Hospital is a 740-bed Level Itrauma center, with 55,000 ED visits per year and a new UrgentCare facility will open in the fall of 2001. Our residency has 12positions per year. Greenville has the benefits of being a veryfamily-oriented community and a college town.Compensation is competitive and commensurate withqualifications; an excellent fringe benefits program is provided.Screening begins summer of 2001 and will remain open untilfilled. This is an excellent opportunity to join a rapidly-growingemergency department in the coastal plains of eastern NorthCarolina, just ninety minutes from the Atlantic Ocean.

Please submit letter of interest and curriculum vitae to:

Nicholas Benson, MD, MBAProfessor and ChairDepartment of Emergency MedicineThe Brody School of Medicine at East Carolina University600 Moye BoulevardGreenville, North Carolina, 27858-4354Phone 252-816-4757; Fax 252-816-5014

ECU is an EEO/AA employer and accommodated individuals with disabilities. Applicants must comply with theImmigration Reform and Control Act. Proper documentation of identity and employability required at the time ofemployment. Current references must be provided upon request.

www.ecu.edu/med www.uhseast.com

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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 are seeking anestablished clinician scientist to hold the Endowed

DISTINGUISHED 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 research withspecial emphasis on Cardiovascular, Neurovascular,Toxicology/HBO, and Outcomes investigation. This Endowed Chairoffers a special opportunity for an individual to pursue a leadershipposition in Emergency Medicine.

Individuals interested in this opportunity are encouraged to contact: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

Academic Emergency MedicineThe Department of Emergency Medicine, Wright State University

School of Medicine seeks a faculty member at the Instructor, Assistantor Associate Professor level. Faculty rank and salary arecommensurate with the candidate’s professional qualifications andSchool of Medicine standards. Faculty activities include medicaleducation at all levels, curriculum coordination, administration andpatient care. An interest and ability in clinical and classroomeducation are preferred. Requirements for appointees include:Instructor, Board prepared; Assistant, Board Certified; Associate, boardCertified and 5 years Emergency Medicine experience. All must begraduates of Emergency Medicine Residency and eligible for Ohiolicense. Applicants should send curriculum vitae and names of threereferences to:

Glenn C. Hamilton, MD, MSMDepartment of Emergency Medicine

3525 Southern Blvd., Kettering, OH 45429Phone: (937) 296-7839 • Fax: (937) 296-4287

email: glenn.hamilton@wright.edu

Consideration of applications begins September 15, 2001 and willcontinue until the positions are filled. Wright State University is an

AAEO Employer.

completed training in an Emergency Medicine Residency Program. He orshe should have a strong interest, or record, in an academic career and adesire to focus on outcomes research. If appropriate, the selectedinvestigator will be allowed sufficient non-clinical time to complete theVanderbilt MPH program during his or her two years. This position willhave up to 80% protected time and start-up funding. Secretarial, researchnurse, and statistical support will be provided, along with a premiumdiscretionary research package. Appointments will be commensurate withthe individuals level of achievement. Excellent salary and benefits in agreat community. Please reply to Corey M. Slovis, MD, Chairman,Department of Emergency Medicine, Vanderbilt University, Room 703,Oxford House, Nashville, TN 37232-4700, E-mail:corey.slovis@mcmail.vanderbilt.edu.

VIRGINIA COMMONWEALTH UNIVERSITY HEALTH SYSTEM: TheDepartment of Emergency Medicine at MCV Hospitals and Physicians ofVirginia Commonwealth University Health System seeks physicians BC inEmergency Medicine to fill key faculty positions as the Vice Chairman ofAcademic Affairs, as well as a Toxicologist to serve as the MedicalDirector of the VA. Poison Control Center (ABMT and/or ABEMsubspecialty examination required). In addition, we seek BC/BP EMphysicians to fill clinical teaching positions. All positions include anexcellent compensation package. Forward CV to: Joseph Ornato, MD,FACC, FACEP, Professor & Chairman, Emergency Medicine,MCVH&P/VCU, Box 980401, Richmond, VA 23298-0401; 804-828-4859, fax: 804-828-4686, www.vcu.edu/mcved. MCVH&P/VCU is anEEO/AA Employer. Women, minorities and persons with disabilities areencouraged to apply.

Newsletter AdvertisingThe SAEM Newsletter is mailed every other month to the5,500 members of SAEM. Advertising is limited to fel-lowship and academic faculty positions. All ads will beposted on the SAEM web site at no additional charge.

Deadline for receipt: December 1 (Jan/Feb issue), March1 (March/April), May 25 (May/June issue), June 15(July/Aug issue), August 1 (Sept/Oct issue), and October15 (Nov/Dec issue). Ads received after the deadline canoften be inserted on a space available basis.

Advertising Rates: Classified Ad (100 words or less)Contact in ad is SAEM member ................$100Contact in ad non-SAEM member ............$125

1/4 - Page Ad (camera ready)3.5" wide x 4.75" high ..........................$300

To place an advertisement, e-mail, fax or mail the ad,along with contact person for future correspondence,telephone and fax numbers, billing address, ad size, andNewsletter issues in which the ad is to appear to: JenniferMastrovito at jmastrovito@saem.org, via fax at (517) 485-0801 or mail to 901 N. Washington Avenue, Lansing, MI48906. For more information or questions, call (517)485-5484 or jmastrovito@saem.org.

All ads will be posted on the SAEM web site at noadditional charge.

FACULTY POSITION

The Division of Emergency Medicine atDuke University Medical Center is working

to develop an Emergency MedicineResidency Program. We are currently seeking

full-time academic faculty members. Thesepositions offer a variety of opportunities for

clinical practice, teaching, and research.Residency training and BC in EM required.Duke University Medical Center EmergencyDepartment is a Level I Trauma Center inDurham, North Carolina, with an annual

volume of 65,000 patient visits. Competitivesalary and benefits. Faculty at all academic

levels are invited to apply.

Please contact:

Kathleen J. Clem, MD, FACEPChief, Division of Emergency Medicine

DUMC 3096, Durham, NC 27710email: clem002@mc.duke.edu

WEST VIRGINIA UNIVERSITYDepartment of Emergency Medicine

Open Rank: The Department of Emergency Medicine at West VirginiaUniversity has a full-time physician faculty position available. Thequalified emergency physician will have patient care and teachingresponsibilities. The WVU Hospital System includes a Level 1 TraumaCenter with 38,000 annual patient visits, a well-establishedEmergency Medicine residency and an active aeromedical transportprogram. The Department has eighteen EM residents involved in a 1,2, 3 program and twenty-six Physician Assistants from throughoutthe country enrolled in a graduate program in Emergency Medicine.Duties include direct patient care and the supervision of medicalstudents, physician assistants, and residents. Significant researchopportunities with an emphasis on injury control are availablethrough the affiliated Center for Rural Emergency Medicine.Morgantown offers both scenic beauty and low cost of living that iswithin commuting distance of Pittsburgh, PA. The area offers lakes,hiking trails, skiing, whitewater sports, and numerous other outdooractivities. Preferred candidates will be residency trained inemergency medicine and board certified/eligible. Salary and rankcommensurate with accomplishments and experience. This positionwill remain active until filled. Applicants should forward a letter ofinterest, curriculum vitae, and names and addresses of threeprofessional references to Ann S. Chinnis, M.D., Chair, Department ofEmergency Medicine, Robert C. Byrd Health Sciences Center, P.O.Box 9149, West Virginia University, Morgantown, WV 26506-9149.West Virginia University is an Affirmative Action/Equal EmploymentOpportunity Employer.

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FACULTY POSITIONS

Department of Emergency MedicineTufts University School of Medicine

Baystate Medical CenterSpringfield, MA 01199

www.baystatehealth.com

Emergency Medicine Researcher: Seeking an emergency medicine researcher withexperience in clinical research and grant writing. The position includes significant pro-tected time; minimal clinical and administrative responsibilities; competitive salary(AAMC Standards) not based on grant support; departmental research staff includinga clinical nurse researcher, a data manager, a team of EM research faculty; office spaceand secretarial support; an academic appointment with Tufts University School ofMedicine consistent with experience and publications.

Pediatric Emergency Medicine: Seeking BC/BE physician in Pediatric EmergencyMedicine and Emergency Medicine to join a regional trauma center with a fullyaccredited Emergency Medicine Residency Training Program and a Children’sHospital. Opportunities include a full unencumbered medical school academicappointment, participation in a Pediatric Emergency Medicine fellowship being devel-oped, and an active clinical research program. You will serve as an attending physicianin the Pediatric and Main ED.

Baystate Medical Center is a Level 1 Trauma Center, 500-bed hospital with an annualED census of 98,000 in Western Massachusetts. Baystate Medical Center has a PGY1-3 emergency medicine residency with 12 residents per year and was recently namedone of the top 15 major teaching hospitals in the United Sates for clinical excellenceand efficient delivery of care (HCIA and The Health Network).

Springfield is located in the beautiful Connecticut River valley at the foothills of theBerkshires with convenient access to coastal New England, Vermont and metropolitanBoston and New York. The area also supports a rich network of academic institutionsincluding the University of Massachusetts and Amherst, Smith, Hampshire and MountHolyoke Colleges.

Please send your letter of interest with curriculum vitae to:

Phil Henneman, MD, Professor and ChairDepartment of Emergency MedicineTufts University School of Medicine

c/o Don Rainwater, Baystate Medical Center759 Chestnut Street, S-1578, Springfield, MA 01199

Tel: (800) 767-6612, Fax: (413) 794-5059E-mail: Don.Rainwater@bhs.org

Baystate Health System is an Equal Opportunity Employer

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Emergency Medicine FoundationResearch Grant Program Overview

All funding periods are July 1, 2002-June 30, 2003 unless otherwise noted. Contact EMF at 800-798-1822 or www.acep.org.

EMF Career Development GrantDescription: A maximum of $50,000 to emergency medicine faculty at the instructor or assistant professor level who needsseed money or release time to begin a promising research project.Deadline: January 11, 2002 Notification: March 20, 2002

EMF Creativity and Innovation in Emergency Medicine GrantDescription: A maximum of $5,000 to support small pilot projects that are new and innovative. It is intended to provide releasetime or provide equipment and supplies for new investigators or for experienced investigators who have a novel idea.Deadline: December 12, 2001 Notification: March 20, 2002

EMF Research Fellowship GrantDescription: A maximum of $35,000 to emergency medicine residency graduates who will spend another year acquiring spe-cific basic or clinical research skills and further didactic training in research methodology.Deadline: January 11, 2002 Notification: March 20, 2002

EMF Resident Research GrantDescription: A maximum of $5,000 to a junior or senior resident to stimulate research at the graduate level.Deadline: December 12, 2001 Notification: March 20, 2002

Riggs Family/EMF Health Policy Research GrantDescription: Between $25,000 and $50,000 for research projects in health policy or health services research topics.Applicants may apply for up to $50,000 of the funds, for a one- or two-year period. The grants are awarded to researchers in thehealth policy or health services area, who have the experience to conduct research on critical health policy issues in emergencymedicine.Deadline: December 5, 2001 Notification: March 20, 2002

EMF/FERNE Neurological Emergencies GrantDescription: This grant program is sponsored by EMF and the Foundation for Education and Research in NeurologicalEmergencies (FERNE). The goal of this directed grant program is to fund research based towards acute disorders of the neuro-logical system, such as the identification and treatment of diseases and injury to the brain, spinal cord and nerves. $50,000 willbe awarded in this program annually.Deadline: January 16, 2001 Notification: March 20, 2002

EMF/SAEM Medical Student Research GrantDescription: This grant program is sponsored by EMF and SAEM. A maximum of $2,400 over 3 months for a medical studentto encourage research in emergency medicine.Deadline: January 18, 2002 Notification: March 20, 2002

EMF/SAEM Innovation in Medical Education ResearchDescription: This grant program is sponsored by EMF and SAEM. A maximum of $5,000 to support projects related to edu-cational techniques pertinent to emergency medicine training.Deadline: November 14, 2001 Notification: March 20, 2002

EMF Directed Research Cardiac Arrest Survival AwardDescription: This grant program is sponsored by the EMF and Wyeth-Ayerst. The goal of this directed grant program is to fundresearch proposals specifically targeting research that is designed to improve the outcome of patients who suffer cardiac arrest.Potential proposals can include basic science, translational or clinical science investigations. A maximum of $100,000 over 2 years(July 1, 2002-June 30, 2004) will be awarded in this program.Deadline: November 21, 2001 Notification: March 20, 2002

EMF/ENAF Team GrantDescription: A maximum of $10,000 to be used for physician and nurse researchers to combine their expertise in order todevelop, plan and implement clinical research in the specialty of emergency care.Deadline: January 11, 2002 Notification: March 20, 2002

EMF Established Investigator AwardDescription: A maximum of $50,000 to established researchers.Deadline: December 19, 2001 Notification: March 20, 2002

Call for Abstracts6th Annual New England Regional SAEM Meeting

April 3, 2002Hoagland-Pincus Conference Center

Shrewsbury, Massachusetts

Keynote Speaker: Ian Stiell, MD, MSc, FRCPC

The Program Committee is now accepting abstracts for review for both oral and poster presentations at the New EnglandRegional SAEM Meeting. The meeting will take place April 3, 2002, 9:00 am-4:00 pm, at the Hoagland-Pincus ConferenceCenter in Shrewsbury, MA; www.umassmed.edu/conferencecenter/

The deadline for abstract submission is Tuesday, January 8, 2002 at 3:00 pm Eastern Time and will be strictly enforced.Only electronic submission via the SAEM online abstract submission form will be accepted. Go to www.saem.org for moreinformation. Acceptance notifications will be sent in late February 2002.

Send registration forms to: Kathleen Shea, Department of Emergency Medicine Research, 1BMC Place, Dowling 1S - Room#1332, Boston, MA 02118-2393; www.kashea@bmc.org

Registration fees: Faculty - $100; Resident/Nurses - $50; EMTs/Students - $25. Late fee after March 20: add $25. Checkspayable to Boston Emergency Physicians Fund.

SAEM

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Call for PhotographsDeadline for receipt: February 15, 2002

Original photographs are invited for presentation at the SAEM 2002 Annual Meeting in St. Louis. Photographsof patients, pathology specimens, gram stains, EKG’s, and radiographic studies or other visual data may besubmitted. Submissions should depict findings that are pathognomonic for a particular diagnosis relevant to thepractice of emergency medicine or findings of unusual interest that have educational value. Acceptedsubmissions will be mounted by SAEM and presented in the "Clinical Pearls" session and/or the "VisualDiagnosis" 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) or a digital copy in JPEG or TIFF format on a disk or by email attachment (resolution at least 640 x 480). Radiographsshould be submitted as glossy photos, not as x-rays. For EKG’s, 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 case history written as an "unknown" in the following format:1. Chief complaint2. History of present illness3. Pertinent physical exam4. Pertinent laboratory data5. One or two questions asking the viewer to identify the diagnosis or pertinent finding.6. Answer(s) and brief discussion of the case, including an explanation of the findings in the photo.7. One to three bulleted take home points or "pearls"

The case history must be 250 words or less with at least one blank line between sections. The case history MUST be submittedas an email attachment to saem@saem.org. If accepted for display SAEM reserves the right to edit 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 themeeting.

Photographs must not appear in a refereed journal prior to the Annual Meeting. Patients should be appropriately masked. Writtenconsent is required for all submissions except for isolated diagnostic studies such as EKGs, radiographs, gram stains, etc. Writtenconsent and release of responsibility, where necessary, must accompany submissions.

All submissions will be considered for publication in Academic Emergency Medicine. In addition, SAEM reserves the right topost selected images and case histories on the SAEM website for teaching purposes. Submitters will be acknowledged. SAEMwill retain the rights to use submitted photographs in future educational projects, with full credit given for the contribution.

Send submissions to SAEM at 901 North Washington Avenue, Lansing, MI 48906 or saem@saem.org.

SAEM

Call for AbstractsSoutheastern Regional SAEM Meeting

April 12-14, 2002Jacksonville, FL

The 2002 Southeastern Regional SAEM Meeting will be held at the beach in Jacksonville, Florida on April 12 – 14, 2002.

The program committee is now accepting abstracts for oral and poster presentations. Abstracts may be submitted electron-ically via the SAEM web site at www.saem@saem.org or by email to se.saem@jax.ufl.edu until January 8, 2002. Please usethe SAEM submission form http://www.saem.org/meetings/regabst.htm if submitting by email.

There will be oral and poster research presentations, round table discussions with leaders in Academic EmergencyMedicine, keynote presentations by world famous emergency physicians, and hands on educational sessions including:

- difficult airway management / alternative airway devices- resuscitation using an advanced patient simulator- emergency ultrasonography

All in a relaxed atmosphere in sight of the Atlantic Ocean!

Registration: medical students and residents are particularly encouraged to attend, and receive a discounted registration feeof $50 (medical students) and $75 (residents). Registration for attending physicians is $110.

To register, contact: Ms. Everlena Owens • phone: (904) 244-4106 • fax: (904) 244-4508 • email everlena.owens@jax.ufl.edu

Hotel: Rooms have been reserved at the host hotel, the Sea Turtle Inn http://www.seaturtle.com/ • phone (800) 874-6000 or(904) 249-7402, for $140 – $180 per night. Mention the SE SAEM conference to receive the discounted rates.

Other Activities: Spouses and children are welcome. The beach is the main attraction. Transportation will be provided forthose who would like to take a day trip to historic downtown St. Augustine on Saturday.

Call for AbstractsSAEM Western Regional

Research ForumSan Diego, CAApril 6-7, 2002

Location: The beautiful Holiday Inn on the BayConference Center overlooking San Diego Harbor

Deadline for abstract submission: January 15, 2002,electronic submission preferred via abstract submis-sion process for national SAEM Annual Meeting. All

regions invited to submit abstracts.

Special EM resident and medical student tracks.

Come and enjoy the sun and surf in San Diego!

Hosted by the University of California, San DiegoEmergency Medicine Residency

SAEM

Call for Abstracts5th Annual SAEM

Mid-Atlantic Regional Meeting

April 11 & 12, 2002First USA Riverfront Arts Center

Wilmington, DE

Keynote Speakers: Marcus Martin, MD, and CharlesPollack, Jr, MA, MD

Special presentation: Joseph Lex, Jr., MD Other highlights include: oral paper and poster scientific

presentations, renowned speakers, convenient location.The deadline for abstract submission is February 1,

2002 via the SAEM online abstract submission form atwww.saem.org.

Hotel reservations can be made at the Sheraton SuitesHotel in Wilmington, DE and transportation will be provid-ed to the meeting site.

For information contact: Patty McGraw, RN, MS or BrianBurgess, MD, Department of Emergency Medicine,Christiana Care Health Services, 4755 Ogletown-StantonRoad, Room L877, Newark, DE 19718; phone: 302-733-4166; fax: 302-733-1625; e-mail: pmcgraw@chris-tianacare.org. The deadline for conference registration isMarch 8, 2002.

SAEM

SAEM

35

CALL FOR ABSTRACTS2002 Annual Meeting

May 19-22 — St. Louis, Missouri

The Program Committee is accepting abstracts for review for oral and poster presentation at the 2002 SAEM AnnualMeeting. Authors are invited to submit original research in all aspects of Emergency Medicine including, but not limited to:abdominal/gastrointestinal/genitourinary pathology, administrative/health care policy, airway/anesthesia/analgesia, CPR,cardiovascular (non-CPR), clinical decision guidelines, computer technologies, diagnostic technologies/radiology,disease/injury prevention, education/professional development, EMS/out-of-hospital, ethics, geriatrics, infectious disease,ischemia/reperfusion, neurology, obstetrics/gynecology, pediatrics, psychiatry/social issues, researchdesign/methodology/statistics, respiratory/ENT disorders, shock/critical care, toxicology/environmental injury, trauma, andwounds/burns/orthopedics.

The deadline for submission of abstracts is Tuesday, January 8, 2002 at 3:00 pm Eastern Time and will be strictlyenforced. Only electronic submissions via the SAEM online abstract submission form will be accepted. The abstractsubmission form and instruction will be available on the SAEM web site at www.saem.org in November. For furtherinformation or questions, contact SAEM at saem@saem.org or 517-485-5484 or via fax at 517-485-0801.

Only reports of original research may be submitted. The data must not have been published in manuscript or abstract formor presented at a national medical scientific meeting prior to the 2002 SAEM Annual Meeting. Original abstracts presentedat other national meetings within 30 days prior to the 2002 Annual Meeting will be considered.

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

SAEM

Board of DirectorsMarcus Martin, MDPresident

Roger Lewis, MD, PhDPresident-Elect

Donald Yealy,MDSecretary-Treasurer

Brian Zink, MDPast President

James Adams, MDFelix Ankel, MDCarey Chisholm, MDGlenn Hamilton, MDJudd Hollander, MDDebra Houry, MD, MPHSusan Stern, 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”

NEWSLETTERNewsletter of the Society for Academic Emergency Medicine

SAEM NEWSLETTER

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

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SAEM regional meeting Calls for Abstracts in this Newsletter