scholarly journals Health human resources for emergency medicine: a framework for the future

CJEM ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 40-44
Author(s):  
Douglas Sinclair ◽  
Peter Toth ◽  
Alecs Chochinov ◽  
John Foote ◽  
Kirsten Johnson ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Annual Meeting ◽  
Royal College ◽  
Training Programs ◽  
Family Physicians ◽  
Quebec City ◽  
Final Report ◽  
Full Time ◽  
Emergency Physicians ◽  
The Future

ABSTRACTIn June of 2016, the Collaborative Working Group (CWG) on the Future of Emergency Medicine presented its final report at the Canadian Association of Emergency Physicians (CAEP) annual meeting in Quebec City. The CWG report made a number of recommendations concerning physician Human Health Resource (HHR) shortfalls in emergency medicine, specific changes for both the Royal College of Physicians and Surgeons of Canada (FRCPC) and the College of Family Physicians of Canada (CCFP-EM) training programs, HHR needs in rural and remote hospitals, future collaboration of the CCFP-EM and FRCPC programs, and directions for future research. All recommendations were endorsed by CAEP, the Royal College of Physicians and Surgeons of Canada (RCPSC), and the College of Family Physicians of Canada (CFPC). The CWG report was published in CJEM and has served as a basis for ongoing discussion in the emergency medicine community in Canada. The CWG identified an estimated shortfall of 478 emergency physicians in Canada in 2016, rising to 1071 by 2020 and 1518 by 2025 assuming no expansion of EM residency training capacity. In 2017, the CAEP board struck a new committee, The Future of Emergency Medicine in Canada (FEMC), to advocate with appropriate stakeholders to implement the CWG recommendations and to continue with this important work. FEMC led a workshop at CAEP 2018 in Calgary to develop a regional approach to HHR advocacy, recognizing different realities in each province and region. There was wide representation at this workshop and a rich and passionate discussion among those present. This paper represents the output of the workshop and will guide subsequent deliberations by FEMC. FEMC has set the following three goals as we work toward the overarching purpose to improve timely access to high quality emergency care: (1) to define and describe categories of emergency departments (EDs) in Canada, (2) define the full time equivalents required by category of ED in Canada, and (3) recommend the ideal combination of training and certification for emergency physicians in Canada. A fourth goal supports the other three goals: (4) urge further consideration and implementation of the CWG-EM recommendations related to coordination and optimization of the current two training programs. We believe that goals 1 and 2 can largely be accomplished by the CAEP annual meeting in 2020, and goal 3 by the CAEP annual meeting in 2021. Goal 4 is ongoing with both the RCPSC and the CFPC. We urge the EM community across Canada to engage with our committee to support improved access and EM care for all Canadians.

scholarly journals Building a national organization of future emergency medicine physicians

CJEM ◽  
1999 ◽  
Vol 1 (02) ◽  
pp. 132
Author(s):  
Jason R. Frank
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Royal College ◽  
Training Programs ◽  
Emergency Physicians ◽  
National Organization ◽  
New Family ◽  
Canadian Association ◽  
Family Medicine Residents

Resident interest in emergency medicine (EM) is on the rise. Each year, postgraduate matches add to the ranks of Canadian EM residents, and the Canadian Association of Emergency Physicians (CAEP) Residents’ Section (RS) continues to expand. The numbers are inspiring. This year, 16 residents accepted Royal College EM postgraduate year-1 (PGY-1) slots. Many more began their CCFP(EM) PGY-3 year, and this doesn’t include the residents who matched separately to EM training programs in Quebec. At the same time, the Canadian Resident Matching Service (CaRMS) matched about 433 new Family Medicine residents and 63 new Pediatrics residents. A significant number of these groups will also go on to develop interests and skills in EM.

31. The birth of a new specialty: The history of emergency medicine in Canada

2007 ◽  
Vol 30 (4) ◽  
pp. 44 ◽  
Author(s):  
R. Elyas
Keyword(s):  
Emergency Medicine ◽  
Royal College ◽  
Emergency Departments ◽  
Clinical Medicine ◽  
Task Force ◽  
Family Physicians ◽  
Care Providers ◽  
Emergency Physicians ◽  
Canadian Association ◽  
History Of

Modern day emergency rooms across Canada have almost completely transformed over the past 30 years; perhaps more so than any other specialty. Before the 1970’s, it was primarily general practitioners working on a part-time basis who ran our emergency departments. Some hospitals used interns and residents as first-line emergency care providers, often under the direction of a surgeon or internist. Emergency Medicine has evolved into a highly sophisticated and respected medical specialty that extends beyond clinical medicine, into both research and academia. The appeal of Emergency Medicine is so great that it is now one of the most sought after specialties in the annual CaRMS match. The success story of Emergency Medicine is characterized by the tireless efforts and determination of its founders across the country. They fought for adequate and supervised care of the acutely ill or traumatized patient, believing in a special body of knowledge that should be available to physicians who spend most, if not all, their time in Emergency Departments. In 1977, these founders formally united and The Canadian Association of Emergency Physicians was born. A few years later, in 1980, Emergency Medicine was finally designated as a free-standing specialty by the Royal College of Physicians and Surgeons of Canada. Meanwhile, the College of Family Physicians of Canada also sought to establish a parallel route for Emergency Training of Family Physicians, feeling that Emergency Medicine lay within the realm of Family Medicine. The result was that both colleges established Emergency Medicine training programs that exist until this day. Using journals, archives, a survey, and interviews, the paper will trace the history of the professionalization of Emergency Medicine in Canada. Johnson R. The Canadian Association of Emergency Physicians. The Journal of Emergency Medicine 1993; 11:362-364. Reudy J, Seaton T, Walker D, Rowat B, Cassie J. Report of the Task Force on Emergency Medicine: RCPSC Accreditation Section, 1988. Walker DMC. History and Development of the Royal College Specialty of Emergency Medicine. Annals Royal College of Physicians and Surgeons of Canada 1987; 20:349-352.

scholarly journals Emergency medicine training demographics of physicians working in rural and regional southwestern Ontario emergency departments

CJEM ◽  
2007 ◽  
Vol 9 (06) ◽  
pp. 449-452 ◽  
Author(s):  
Munsif Bhimani ◽  
Gordon Dickie ◽  
Shelley McLeod ◽  
Daniel Kim
Keyword(s):  
Emergency Medicine ◽  
Family Medicine ◽  
Residency Training ◽  
Emergency Departments ◽  
Training Programs ◽  
Family Physicians ◽  
Demographic Information ◽  
Trauma Resuscitation ◽  
Curriculum Content

ABSTRACT Objectives: We sought to determine the emergency medicine training demographics of physicians working in rural and regional emergency departments (EDs) in southwestern Ontario. Methods: A confidential 8-item survey was mailed to ED chiefs in 32 community EDs in southwestern Ontario during the month of March 2005. This study was limited to nonacademic centres. Results: Responses were received from 25 (78.1%) of the surveyed EDs, and demographic information on 256 physicians working in those EDs was obtained. Of this total, 181 (70.1%) physicians had no formal emergency medicine (EM) training. Most were members of the College of Family Physicians of Canada (CCFPs). The minimum qualification to work in the surveyed EDs was a CCFP in 8 EDs (32.0%) and a CCFP with Advanced Cardiac and Trauma Resuscitation Courses (ACLS and ATLS) in 17 EDs (68.0%). None of the surveyed EDs required a CCFP(EM) or FRCP(EM) certification, even in population centres larger than 50 000. Conclusion: The majority of physicians working in southwestern Ontario community EDs graduated from family medicine residencies, and most have no formal EM training or certification. This information is of relevance to both family medicine and emergency medicine residency training programs. It should be considered in the determination of curriculum content and the appropriate number of residency positions.

scholarly journals A voice for future EM physicians

CJEM ◽  
1999 ◽  
Vol 1 (01) ◽  
pp. 47
Author(s):  
Jason R. Frank
Keyword(s):  
Emergency Medicine ◽  
Emergency Physicians ◽  
The Future ◽  
Future Leaders

Welcome to the first section on “Resident Issues” in our new journal. With this section, CAEP reaffirms its commitment to the future of Canadian emergency medicine and future leaders in our specialty. Resident Issues will focus on work by and about future emergency physicians in Canada. The overall goal of this section is to promote

scholarly journals “The Future of Emergency Medicine” Inaugural address to the First Canadian EM Residents Workshop

CJEM ◽  
2000 ◽  
Vol 2 (04) ◽  
pp. 262-264 ◽  
Author(s):  
Isser Dubinsky
Keyword(s):  
Emergency Medicine ◽  
Emergency Services ◽  
Emergency Physicians ◽  
Inaugural Address ◽  
Health Network ◽  
Canadian Association ◽  
The Future ◽  
National Forum ◽  
The University

On June 10 to 11 this year, the Residents’ Section of the Canadian Association of Emergency Physicians (CAEP-RS) held its first official national forum for future emergency physicians — the First Canadian EM Residents Workshop, in conjunction with CAEP 2000. To celebrate the event, the RS decided to invite a nationally recognized emergency medicine leader, advocate, and teacher to be the first to address the Annual Residents’ Dinner. We were grateful for the privilege of having Dr. Isser Dubinsky be that person. Dr. Dubinsky, currently Chief of Emergency Services at the University Health Network in Toronto, was asked to speak about “The Future of Emergency Medicine.” Dr. Dubinsky's speech, filled with warmth, wisdom, and humanity, is transcribed below. — Jason Frank, MD, Chair CAEP-RS

Emergency medicine teaching faculty perceptions about formal academic sessions: “What’s in it for us?”

CJEM ◽  
2005 ◽  
Vol 7 (01) ◽  
pp. 36-41 ◽  
Author(s):  
Glen W. Bandiera ◽  
Laurie Morrison
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Social Interaction ◽  
Continuing Medical Education ◽  
A Priori ◽  
Theory Approach ◽  
Full Time ◽  
Perceived Benefits ◽  
Emergency Physicians ◽  
Part Time

ABSTRACT Background: Little is known about factors affecting emergency physician attendance at formal academic teaching sessions or what emergency physicians believe to be the benefits derived from attending these activities. Objectives: To determine what factors influence emergency medicine faculty attendance at formal academic rounds, what benefits they derive from attendance, and what differences in perceptions there are between full-time clinical and part-time clinical academic faculty. Methods: A survey was sent to all emergency physicians with academic appointments at one institution. Responses were tabulated dichotomously (yes/no) for checklist answers and analyzed using a 2-person grounded theory approach for open answers based on an a priori analysis plan. Differences between full-time and part-time faculty were compared using the chi-squared test for significance. Results: Response rate was 73.8% (48/65). Significant impediments to attendance included clinical responsibilities (75%), professional responsibilities (52.1%), personal responsibilities (33.3%), location (31.2%) and time (27.1%). Perceived benefits of attending rounds were: continuing medical education, social interaction, teaching opportunities, interaction with residents, comparing one's practice with peers, improving teaching techniques, and enjoyment of the format. There were no statistically significant differences between groups' responses. Conclusions: Emergency physicians in our study attend formal teaching sessions infrequently, suggesting that the perceived benefits do not outweigh impediments to attendance. The single main impediment, competing responsibilities, is difficult to modify for emergency physicians. Strategies to increase faculty attendance should focus on enhancing the main perceived benefits: continuing medical education, social interaction and educational development. Faculty learn from themselves and from residents during formal teaching sessions.

scholarly journals What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

CJEM ◽  
2015 ◽  
Vol 17 (6) ◽  
pp. 601-608 ◽  
Author(s):  
Catherine Patocka ◽  
Joel Turner ◽  
Jeffrey Wiseman
Keyword(s):  
Emergency Medicine ◽  
Training Programs ◽  
Evidence Based ◽  
Emergency Physicians ◽  
Training Context ◽  
Purposive Sampling ◽  
Educational Framework ◽  
Context Knowledge ◽  
Electrocardiogram Ecg ◽  
Ecg Interpretation

AbstractObjectiveThere is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee.MethodsWe developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds.ResultsA purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered “must know” diagnoses, 61 (50%) “should know” diagnoses, and 7 (6%) “nice to know” diagnoses.ConclusionWe have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

scholarly journals P066: Comfort of emergency medicine physicians in implementing early goal directed therapy for sepsis

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S100-S101
Author(s):  
J. Kaicker ◽  
A. Pardhan ◽  
S. Upadhye ◽  
A. Healey ◽  
T.M. Chan
Keyword(s):  
Emergency Medicine ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Serum Lactate ◽  
Training Data ◽  
Full Time ◽  
Emergency Physicians ◽  
Respiratory Compromise ◽  
Accurate Identification ◽  
Electronic Survey

Introduction: The recently published ProMISe, ARISE and ProCESS trials demonstrated that protocol-based resuscitation (EGDT) of ER patients in whom septic shock was diagnosed did not improve outcome when compared to usual care. The objective of this project was to survey McMaster emergency physicians in areas including sepsis definition, clinical recognition in adults, self-rated skills assessment, attitudes towards skills augmentation and compare results to the cohort surveyed 11 years ago, close to the introduction of EGDT. Methods: Full time faculty at McMaster’s Department of Emergency Medicine and ER residents were surveyed anonymously using an electronic survey. The questions covered demographics and training data, identification of septic patients, sepsis intervention and attitudes towards skills augmentation. Results: A total of 18 physicians responded to the electronic survey to date. All respondents were able to correctly input definitions for SIRS, sepsis, severe sepsis and septic shock. The majority of respondents felt the best strategy to identify potentially septic adults involved monitoring abnormal vital signs (67%) with some stating serum lactate assessment (33%). Of the 11 possible interventions options provided to care for septic patients, respondents appeared more comfortable with placement of lines, giving vasopressors and appropriate use of fluids for resuscitation. This was compared to more specialized interventions like initiating IV steroids in vasopressor dependant shock despite adequate fluid loading. 22% of respondents believed that patients without respiratory compromise with clinically severe sepsis should be intubated which was found to be 48% in the previous cohort surveyed 11 years ago. 78% believed patients in septic shock without respiratory comprise should be intubated, reassuringly similar to the previous survey result of 87%. Conclusion: Emergency physicians at our Canadian institution are comfortable with the skill set required to care for patients with sepsis. Respondents surveyed to date were all comfortable with important resuscitative measures including accurate identification, placement of lines and appropriate fluid administration and were receptive to additional training. Our study emphasizes that our physicians have the skill set to identify and provide care for sepsis using their clinical judgment in cases that may not require protocolized based care.

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