President's Message

Advocating to Make Emergency Medicine the Best Specialty It Can Be

EMRA helps make you the best doctor you can be, through our amazing on-shift educational resources like the EMRA Antibiotic Guide, the best leader you can be by funding more than 100 medical student and resident leadership positions to shape the future of our specialty, and helps make EM the best specialty it can be, through our unrivaled advocacy. With so many exciting advocacy initiatives going on, I wanted to share some of them with you.

Supporting Emergency Physicians’ Autonomy
The EM community was shocked when the anesthesiologists released guidelines stating that ketamine and propofol, two of our most commonly administered sedation agents, should only be provided by qualified anesthesia providers.1 EMRA banded together with ACEP and 8 other medical specialty societies – including the gastroenterologists, oral surgeons, and cardiologists – to create an Unscheduled Procedural Sedation Consensus Practice Guideline to help prove to hospital administrators and regulators alike that these agents can and should be administered by emergency physicians and other specialists.

Standing Up for Residents’ Scholarly Activity
The ACGME requires all residents to perform “scholarly activity.” Because emergency medicine has always been innovative, it has adopted a broad definition of what counts toward this requirement. In addition to peer-reviewed research articles, both EMRA and the ACGME’s Review Committee for Emergency Medicine have supported non-peer reviewed work such as podcasts and case reports, conference presentations, and textbook chapters.2 In addition, EMRA also believes curriculum development and national committee leadership roles satisfy the requirement by enriching our training.3 However, an upcoming paper by the SAEM Research Directors Interest Group argues for a narrower definition of what constitutes scholarly activity, so EMRA joined forces with CORD and ACOEP-RSO to stand up for residents and will publish a rebuttal.

Protecting Core Faculty
Historically, the ACGME required EDs to grant EM core faculty protected time to teach and mentor residents.4 However, the newest proposed Common Program Requirements remove that protection.5 EMRA believes this could have disastrous consequences for resident scholarly activity and mentorship, as well as faculty and resident wellness. That’s why we teamed up with ACEP, CORD, SAEM, AAEM, AAEM/RSA, and AACEM to oppose this change. The ACGME decided to reconsider this issue, and while we’re still waiting for the final verdict, we remain hopeful.6

Supporting Gun Violence Research
After the tragic death of Dr. Tamara O’Neal, an emergency physician who was gunned down at her hospital, EMRA spoke out about the need for more gun violence research. We also joined 14 national medical societies across multiple specialties to donate thousands of dollars to supporting firearm injury prevention research through the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM).7

Promoting Women in Emergency Medicine
In October, a group of motivated residents identified a structural disadvantage for female EM residents: the family leave policy. Unlike OB/GYN, Internal Medicine, Pediatrics, Radiology, Anesthesiology, and Dermatology, EM residents are not allowed to carry over unused family leave weeks from year to year.8 This imposes undue burdens upon residents, particularly those having children. After the issue was raised, EMRA created a joint task force with the American Board of Emergency Medicine (ABEM), and plans to offer a solution for consideration at the next EMRA Representative Council meeting in April. EMRA also sponsored the FemInEM Idea Exchange and is committed to promoting diversity and equity in our field. 

Looking to the Future of EM
Historically the need for board-certified emergency physicians far outstripped the number of them. But with the dramatic growth in the number of EM residencies during the past decade and the proliferation of Advanced Practice Providers (APPs) in EDs, that might start to change. EMRA cares deeply that today’s residents will have fulfilling opportunities in the future, so we partnered with ACEP and world-renowned Health Workforce researchers to create an Advanced Practice Providers Task Force to help define the scope of practice for APPs in EM, as well as an EM Workforce Task Force to project the supply, demand, and opportunities for emergency physicians in 10-20 years. While we don’t yet know what the future holds, we’re making sure residents have a seat at the table and won’t hesitate to stand up for our members.

If you want to learn more about these or any other issues, or if you’d like to be more involved, feel free to email me at president@emra.org.


References
1. Green SM, Roback MG, Krauss BS. The Newest Threat to Emergency Department Sedation. Ann Emerg Med. 2018. 72(2):115-119.
2. ACGME Review Committee for Emergency Medicine. Frequently Asked Questions: Emergency Medicine. October 2017.
3. EMRA. Policy Compendium. December 2018.
4. ACGME. Program Requirements for Graduate Medical Education in Emergency Medicine. July 2017. Online.
5. ACGME. Common Program Requirements (Residency). June 2018.
6. EMRA. EMRA responds to the New ACGME Common Program Requirements and Proposed Requirement Changes to the RC-EM.November 2018.
7. EMRA. Statement on Mercy Hospital Mass Shootings. November 2018.
8. Solnick R. “Resolution F18-1: Leave Policy for EM residents.” Emergency Medicine Residents’ Association. Oct 2018. Online. https://www.emra.org/be-involved/be-a-leader/representative-council/2018-fall-resolutions/resolution-f18-1/

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