Early in my PGY-2 year, one of my chief residents said, “Hey Brea, do you want to be our program representative to EMRA?”
I agreed, despite having no idea what that would entail. A few months later, I wandered the halls of ACEP18 in San Diego, looking for EMRA’s Representative Council meeting (RepCo). Resident representatives from every EM program in the country attend RepCo, during which national resolutions written by medical students, residents, and fellows are discussed, modified, and voted on. Sitting quietly in the Ohio section, I felt like an imposter holding my voting card. I was responsible for my program’s 40 votes, but I did not know how my colleagues back home felt about these resolutions, especially given that they could affect our practice for years to come. At that moment I decided change was necessary. Our program needed to discuss these resolutions ahead of time, and we needed a democratically elected and funded representative to EMRA’s RepCo.
To start, I drafted a position statement that outlined not only the representative’s duties and responsibilities, but also the process to select the resident who would speak and vote on our behalf. I discussed this plan with program leadership and secured their approval.
Next, I wrote a funding proposal so our representative could be reimbursed for travel and lodging at the EMRA RepCo meetings that occur twice a year. I sent this proposal to our institution’s GME office, and it was approved with minor modifications.
These templates can help you do the same at your program:
- Sample EMRA Program Representative Position Statement: https://bit.ly/30jVaCJ
- Sample Funding Proposal for EMRA Program Representative: https://bit.ly/2t5NOq4
The Sales Pitch
Clearly outline why money should be spent. The first argument I made was that participation in organized medicine is increasingly important, but it is nearly impossible to transition from ED pit doc to state representative at ACEP Council without prior experience. Attending EMRA’s RepCo meetings is a great entry point to organized medicine. Furthermore, the RepCo environment fosters group learning about parliamentary process and procedure. This is an unparalleled learning opportunity.
Additionally, an officially funded EMRA program rep provides an opportunity to introduce organized medicine to all of the EM residents. Resolutions must be discussed with the whole program so the representative knows how to vote on the RepCo floor. I helped our representative lead a 1-hour discussion during protected time at grand rounds, during which residents learned how to interpret resolutions, participated in the debate process, and voted on issues that directly affect them. This was a valuable learning experience for the whole program. Given that the topics of resolutions change every cycle, it will be a new experience and discussion each time.
During the RepCo Town Hall last year, attendees discussed how (or if) EMRA’s resident moonlighting policy should be revised. Resident representatives from across the country debated the policy’s language, and it was obvious there was no “one-size-fits-all” solution. Every EM program is different (urban vs. rural, academic vs. community, small vs. big); given this diversity, moonlighting needs and expectations are varied. Without giving residents equal opportunities to speak on behalf of their programs, moonlighting may have become restricted to purely rural facilities, limiting supported opportunities elsewhere. This is one example why having a seat at the table is so important.
No Money? No Problem
Invariably, some programs will not fund a resident representative to attend RepCo meetings in person. That doesn’t mean the program can’t be fully engaged; EMRA accommodates virtual attendance and remote voting. Every program should elect a representative, discuss resolutions ahead of time as a group, and make sure their vote is recorded during the biannual RepCo meetings.