July-August 2014

44 Pages·2014·5.23 MB·English

Celebrating Our 25th Anniversary
NEWSLETTER
2340 S. River Road, Suite 208 | Des Plaines, IL 60018 | 847-813-9823 | www.saem.org
JULY-AUGUST 2014 VOLUME XXIX NUMBER 4
NEW SAEM PRESIDENT
Robert S. Hockberger, MD
ETHICS
IN ACTION
Adolescent Informed Consent
THE EVOLUTION
of the SAEM
Social Media Committee
NEW RESEARCH-FOCUSED
RESIDENCY
The Yale Emergency
Scholars Program
ANNUAL MEETING
Recap
To lead the advancement of emergency care through education and research,
advocacy, and professional development in academic emergency medicine.
SAEM STAFF
2014-2015
Chief Executive Officer
Ronald S. Moen
BOARD OF DIRECTORS
Ext. 212, [email protected]
Director of Information
Services & Administration
Robert S. Hockberger, MD
James Pearson
President
Ext. 225, [email protected]
Harbor-UCLA Medical Center
Accountant
Mai Luu, MSA
Ext. 208, [email protected]
Deborah B. Diercks, MD, MSc
Accounting Assistant President-Elect
Dipesh Patel, CFE, MSA University of California, Davis Medical Center
Ext. 207, [email protected]
Communications Manager/Newsletter Editor
Andra L. Blomkalns, MD
Karen Freund
Secretary-Treasurer
Ext. 202, [email protected]
University of Cincinnati College of Medicine
Assistant to the Executive Director
Michelle Orlow
Ext. 206, [email protected]
Alan E. Jones, MD
Education Coordinator Past President
LaTanya Morris University of Mississippi Medical Center
Ext. 214, [email protected]
Grants & Foundation Manager
Steven B. Bird, MD
Melissa McMillian, CNP
University of Massachusetts Medical School
Ext. 203, [email protected]
Marketing & Membership Manager Kathleen J. Clem, MD, FACEP
Holly Byrd-Duncan, MBA Loma Linda University School of Medicine
Ext. 210, [email protected]
D. Mark Courtney, MD
Meeting Planner
Maryanne Greketis, CMP Northwestern University Feinberg School of Medicine
Ext. 209, [email protected]
James F. Holmes, Jr., MD, MPH
Membership Coordinator
University of California, Davis, Health System
George Greaves
Ext. 211, [email protected]
Lauren Hudak, MD
Systems Administrator/Database Analyst Resident Board Member
Michael Reed Emory University School of Med
Ext. 205, [email protected]
Amy H. Kaji, MD, PhD
Administrative Assistant
Sarah Buchanan Harbor-UCLA Medical Center
Ext. 201, [email protected]
Ian B.K. Martin, MD
Administrative Assistant
University of North Carolina School of Medicine
Elizabeth Oshinson

Ext. 204, [email protected]
The SAEM Newsletter is published bimonthly by the Society for Academic
AEM STAFF
Emergency Medicine. The opinions expressed in this publication are those
of the authors and do not necessarily reflect those of SAEM.
Editor in Chief
David C. Cone, MD
For Newsletter archives visit
[email protected]
http://www.saem.org/publications/newsletters
Journal Editor
Kathleen Seal © 2014 Society for Academic Emergency Medicine. All rights reserved. No part
[email protected] of this publication may be reproduced, stored, or transmitted in any form or by
any means without prior permission in writing from the copyright holder.
Journal Manager
Sandi Arjona
[email protected]
HIGHLIGHTS
NEWSLETTER
GUHIDIEGLHINLIEGSHTS
NEWSLETTER GUIDELINES 4
President’s Message
SAEM invites submissions to the Newsletter, published
bim4onthly six times a year in identical online and paper
editions , pertaining tPor aecsaiddeemnict’ sem Meregsenscayg meedicine in
areas including:
5
 Clinical practice Chief Executive’s Message
 Education of EM residents, off-service residents,
medical students, and fellows
5
 Faculty development, CME
Executive Director’s Message
 Politics and economics as they pertain to the
academic environment 7
 General announcements and notices Ethics in Action
Submit materials for consideration for publication at
6
[email protected]. Please include the names and
Ethics in Action
affiliations of authors and a means of contact.
8 Resident and Student
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PRESIDENT’S MESSAGE
Robert S. Hockberger, MD
David Geffen School of Medicine at UCLA
Harbor-UCLA Medical Center
My career in emergency medicine began
with a senior medical student rotation at
the University of Chicago in 1975. I was a
student at the Loyola School of Medicine
across town and had liked every rotation
in my junior year, but none enough to
commit to as a lifelong career. My advisor
played tennis on weekends with a surgical
colleague at the U of C who had recently
started a residency training program in
Robert S. Hockberger, MD emergency medicine, a very new specialty
at the time, and suggested I give it a
try. I took his advice and was instantly drawn to the excitement
bordering on chaos, the varied medical and personal problems
of the patients, and the sense of individual commitment and
coordinated teamwork among the ED staff as they struggled
together to find the best solution to each patient’s problem. I was
also impressed with the charismatic leader of the department,
Dr. Jim Niemann, Dr. Bob Hockberger and Dr. Roger Lewis
my advisor’s tennis partner, Dr. Peter Rosen, who made the
faculty and residents in his department feel they were part of an
been extremely fortunate over the years to work with outstanding
academic family committed to fostering each other’s personal
faculty who have labored diligently to pursue their own visions for
and professional growth, while providing an important service to
what they hope to contribute to the field of emergency medicine,
society.
and those accomplishments have reflected quite positively upon
I joined the family and accepted a faculty position in the our academic family. While I did not become active in SAEM until
department following my residency because I enjoyed teaching later in my career, as a department chair I was able to see how
the junior residents, interns and students, and thought it would the involvement of my faculty aided their development as leaders
be fun to continue to learn and grow. Toward the end of my first within academic EM. As examples, Dr. Jim Niemann served as
year as a faculty member I read a book on career planning that SAEM president in 1988-89 and received the SAEM Leadership
recommended a two-part exercise. First, you write a paragraph Award in 1993, and Dr. Roger Lewis served as SAEM president
describing what is important to you, what you are good at and what in 2002-03 and received the SAEM Academic Excellence Award
you enjoy doing, and with that information and a little imagination, in 2005. Now, as I enter the next phase of my academic career, I
what you think you might accomplish with your life. Then you pare am both honored and excited by the opportunity to serve SAEM
the paragraph back to seven words or less, to create a vision and contribute to initiatives that will advance its mission.
statement for your life to help inform important career decisions.
One hundred people over 90 years of age were once asked
My statement was “Serve the poor through medical education
what they would do differently if given the opportunity to live
activities.” With that thought in my mind, the decision to accept
their lives over. The three most common answers were (1) they
a residency director position at a public hospital (Harbor-UCLA
would reflect more on what they were doing, and why they were
Medical Center) was an easy one when it was offered to me
doing it, (2) they would take more chances, and (3) they would do
several months later.
more things that would leave a lasting impact. While pursuing an
After spending eight years as the residency director at Harbor academic career doesn’t guarantee personal fulfillment, it does
I was offered the position of department chair. I performed the set the stage for it by providing us with the opportunity to reflect
paragraph-paring exercise again, using what I had learned about (at each stage of our careers, as we climb the academic ladder
myself since the previous effort, and came up with “Provide and encounter different opportunities), to take chances (as we
leadership to highly committed professional colleagues.” With that strive to become better educators, scholars and leaders), and to
thought in my mind, I accepted the position and approached the participate in endeavors that have lasting effects on the lives of
job as though I were the residency director for the faculty, helping
them develop their academic careers while they helped me develop
and run our patient care, education and research programs. I’ve Continued on Page 6
4
CHIEF EXECUTIVE’S MESSAGE
A BIG THANK YOU… AND WHAT’S IN A NAME?
I would like to say a big thank you to all further guidance in a particular area. This new program will utilize
the individuals who made SAEM’s 25th digital technologies to match a mentor and a mentee, and facilitate
anniversary Annual Meeting such a big direct communication between the two. Our hope is that these
success. The Program Committee, under matches will ultimately facilitate face-to-face interaction at various
the able direction of Dr. Chris Ross, worked meetings throughout the years as well.
tirelessly to put together the largest and, by
I am sure that every reader of this article can easily identify
all accounts, the very best program ever for
several individuals who have served as personal and professional
SAEM. SAEM’s academies provided great
mentors. I certainly can think of individuals who in some ways
programming, social events and special
were formal mentors. They were teachers, advisors, and others
sessions on Tuesday that enhanced the
who, through their formal positions, helped me while I was in
Ronald S. Moen entire meeting; and other special programs,
college and graduate school. But as I think about this topic, I
including the Consensus Conference, the
am also drawn to think about some of the other individuals who
Grant Writing Workshop, Sim Wars, and SonoGames®, were
served as my mentors, and may not have even realized that they
also acclaimed for their excellence. Attendance was at an all-time
were providing me with excellent guidance. Some were other
high, in spite of the difficult weather in the Dallas area and the
teachers with whom I had only a passing acquaintance, while
rest of the country at the start of the meeting. Some members
others were colleagues who by their very nature and interaction
told me that it took them 36 hours to get from the East Coast to
with me provided unique experiences that helped me grow and
Dallas, with detours to many different cities along the way instead
develop my skills and confidence in how I approached situations.
of the non-stop flights that had been booked. That is a real tribute
I am always impressed by the constant interactions among SAEM
to our members and their commitment to academic emergency
members at our meetings. Clusters of individuals can be found
medicine. Now the challenge for Dr. Ali Raja and his 2015 Program
all over the meeting sites, whether in side conversations during
Committee is to do even better to engage and excite our members.
breaks in presentations, over meals or coffee, or in the late-night
The Board of Directors has approved a number of changes to the
venues that are so popular with our members.
overall meeting schedule that should further enhance attendees’
experience. Watch for these changes to be announced over time In other situations, we seek out coaches for particular skill
in the Newsletter and on the website. development or a more critical analysis of our strengths and
weaknesses. Often we hire coaches to help us understand how
For many years, there has been an emphasis on mentoring,
others perceive us and why we are not achieving something
coaching, leadership development and similar concepts, all
that we desire. This is particularly true in the development of
of which help us to achieve our potential. Whether it is in a
leadership. This year, the Association of Academic Chairs of
technical field, medicine, social work, business management
Emergency Medicine (AACEM), under the leadership of Dr. Brian
or in other areas, these themes keep reappearing. So too in
Zink, developed a yearlong program geared to the meet the needs
academic emergency medicine. Medical school and residency
of newly elected chairs of emergency medicine departments,
training programs rely on quality educational experiences. One
and to reach those who aspire to become chairs of these
must learn the subject matter, but even more important, one
departments in the future. For the past couple of years, the Faculty
must learn to incorporate the facts into some logical method
Development Committee has developed a one-and-a-half-day
of processing the information and interacting with others. One
program for leadership training for senior faculty, which is part of
needs to demonstrate mastery of subject matter, and also satisfy
the Annual Meeting. Another leadership development program is
an instructor that not only do you know the subject matter, but
offered during the Annual Meeting for more junior faculty. Anyone
you also know how to apply it. But beyond these rudimentary
observing these programs will be struck by how intense the
ways of demonstrating competence, we all seek to improve our
interaction becomes between the attendees and faculty; this is
performance and master more of the intangibles that make us
also truly a mentoring program that will have long-term benefits.
really excellent in our chosen field of endeavor. One clear way to
do this is to rely on the mentors we all have in our lives, whether So what is there for you in the process we call “mentoring”?
the relationships they have with us are formal or informal, and Do you have a mentor? Do you want a mentor? What would you
most of us can name those individuals who have influenced our like a mentor to help you with?
development and provided direct or indirect mentoring to help us Jim Pearson, a member of the SAEM staff, will be working with
along in our growth and development. Recently, the SAEM Board a committee of members to develop this program. He would
approved implementation of a comprehensive mentoring program appreciate your thoughts and suggestions. He can be reached at
that will be available to SAEM members as well as medical [email protected].
students who have an interest in emergency medicine. While a
Have a wonderful summer! ◗
lot of mentoring occurs within the residency programs, there is an
increasing need for the identification of mentors with specialized
skills, and demand for matching them with individuals who want
5
Continued from Page 4 many close and long lasting. The accomplishments listed in
my curriculum vitae showed the dean I was productive, but the
others (our colleagues, our patients and our communities). friendships I established while working on those projects brought
me personal satisfaction that will last long after my academic
At our recent Annual Meeting, I had the opportunity to help
career.
orient new board members, to meet with academy leaders and
committee chairs, and to talk with a number of SAEM members With our 25th anniversary meeting behind us, and a new
about our organization’s accomplishments and challenges. While academic year beginning, I encourage you to take this opportunity
doing so, I couldn’t help but reflect on my own experiences to reflect on what you are doing, and why you are doing it, to take
volunteering with EM organizations over the past 35 years (the at least one chance during the coming year, and to think about
EM-RRC, ABEM, ACEP and in the past decade SAEM). Those the legacy you will eventually leave behind. Regardless of what
experiences helped me become a more thoughtful educator, you decide, remember that participation in SAEM can help you
a more productive scholar and a more effective facilitator of develop the skills and relationships necessary to accomplish your
collaborative work. Those things happened, bit by bit, through goals (my wife would say dreams). ◗
a series of relationships that started out traditionally (mentor,
colleague, mentee) but very often evolved into friendships,
2014 ANNUAL MEETING PROGRAM COMMITTEE
Harrison Alter, MD Carolyn Holland, MD Erin McDonough, MD Christopher Ross, MD
Alameda County Medical Center - University of Florida University of Cincinnati Cook County Hospital
Highland Hospital (Program Committee chair)
Jeffrey Hom, MD Henderson McGinnis, MD
Gillian Beauchamp, MD Stony Brook University Wake Forest Baptist Health Cynthia Santos, MD
University of Cincinnati School of Medicine Mount Sinai Medical Center
Joseph Miller, MD
Steve Bird, MD Jason Hoppe, MD Henry Ford Hospital Stacy Sawtelle, MD
University of Massachusetts University of Colorado UCSF Fresno Medical
Angela Mills, MD
Education Program
Jennifer Carey, MD Laura Hopson, MD University of Pennsylvania
University of Massachusetts University of Michigan Todd Seigel, MD
Joel Moll, MD
Lauren Hudak, MD Brown University
Rob Cloutier, MD University of Michigan
Oregon Health & Science University Emory University Sneha Shah, MD
Lewis Nelson, MD
Jennifer Lee Jenkins Levy, MD University of Massachusetts
Moira Davenport, MD New York University
Allegheny General Hospital Johns Hopkins University Richard Sinert, MD
Jason Nomura, MD
Jonathan Jones, MD SUNY-Downstate Medical Center
Kevin Ferguson, MD Christiana Care Health System
University of Florida University of Mississippi Howard Smithline, MD
Medical Center Charissa Pacella, MD Baystate Medical Center
Barbra Forney University of Pittsburgh
Gabor Kelen, MD Lorraine Thibodeau, MD
Compliance Program Manager
Johns Hopkins University Daniel Pallin, MD Albany Medical Center
University of Cincinnati
Brigham and Women’s Hospital /
Hollynn Larrabee, MD R. Jason Thurman, MD
Chris Ghaemmaghami, MD Harvard Medical School
West Virginia University
Vanderbilt University
University of Virginia
Luan Lawson, MD Peter Pryor, MD
Jody Vogel, MD
Eric Gross, MD Brody School of Medicine Denver Health
Denver Health Medical Center
Hennepin County Medical Center at East Carolina University Ali Raja, MD
Justin Williams, MD
Sanjey Gupta, MD Jo Anna Leuck, MD Brigham and Women’s Hospital /
University of Texas
New York Hospital Queens Carolinas Medical Center Harvard Medical School
Health Sciences Center
Todd Guth, MD Jason Liebzeit, MD Linda Regan, MD - San Antonio
University of Denver Emory University School of Medicine Johns Hopkins University
Robert Woolard, MD
Tarlan Hedayati, MD Brandon Maughan, MD Kevin Rodgers, MD Texas Tech University
Cook County Hospital University of Pennsylvania Indiana University Health Sciences Center
6
ETHICS IN ACTION
ADOLESCENT INFORMED CONSENT
Naomi Dreisinger, MD, MS, FAAP statement. Adolescents seeking health care may consent to their
own treatment in the following situations: access to contraception/
Mount Sinai Beth Israel, New York
reproductive care, evaluation and treatment of sexually transmitted
CASE PRESENTATIONS diseases, mental health care, and substance abuse treatments.
A 15-year-old boy presents to your emergency department Adolescents feel strongly about their right to privacy regarding
accompanied by a friend. He explains that he has been having reproductive care, and minors are thus authorized to provide
lower abdominal pain for 2-3 days accompanied by anorexia and consent in these circumstances to assure that they seek care and
nausea, but denies vomiting or fever. The patient seems cautious to minimize the spread of infection. Studies show that without
when discussing his symptoms, and frequently defers to his older confidentiality, many adolescents would avoid medical care,
male friend. When questioned as to the whereabouts of his parents putting themselves and the public at risk. A good doctor-patient
and how best to contact them, the patient states they are out of relationship is based on trust; trust is inherent in the development
town, and cannot remember his mom’s telephone number. Upon of a safe and helpful relationship when treating adolescents for
completion of the physical, you are concerned about appendicitis delicate matters, and thus confidentiality is a necessity.
and begin a work-up including lab tests and possible imaging. At
Under certain circumstances, adolescents may consent to their
this point you become concerned about who will give permission
own medical treatment regardless of treatment type: children
for the evaluation and possible necessary procedures for this
under the age of 18 who are married, have children of their
minor patient.
own, financially support themselves, or are in the military. These
Emergency medicine physicians are fortunate in that consent is children are considered emancipated minors; irrespective of their
not always necessary when treating patients in the ED. In urgent true capacity, they are authorized to consent to their own or their
or emergent situations, treatment required to prevent serious harm children’s medical care. An additional concept is mature minors,
or death is allowed without informed consent. It is possible that our children determined to have actual decision-making capacity:
patient falls within these guidelines, meaning that beginning the they can be granted decision-making authority through a court of
evaluation without proper consent is permissible. Despite this fact, law. Although official in just eight states, the idea of the mature
the case in question brings up several ethical dilemmas. minor is desirable because it utilizes the developing autonomy of
When an adolescent patient presents to the ED without a an adolescent through a fact-specific review analyzing the minor’s
parent, what is the responsibility of the provider? Informed consent ability to make informed decisions that appropriately assess the
is defined as a communicative process that shares information risks and probable consequences of a particular action. Mature
with patients intended to ensure that the patient understands the minors are determined on a case-by-case basis. While the mature
information, and requests permission to proceed. Careful informed minor is an important concept to understand, it is rarely useful in
consent must include an explanation of possible alternatives of care the ED or other circumstances where time is of the essence.
as well as the risks and benefits of a particular procedure. Informed Following the above analysis, let us return to the case at hand.
consent allows patients to use their own value system to determine The patient in question is a 15-year-old boy with abdominal pain.
the need for a particular procedure or test, thereby respecting them Further exploration reveals that the child ran away from home, and
as autonomous individuals. Allowing such autonomous decision was presently staying with the friend who had come with him to
assumes patients are capable of the thought process required for the ED. Medical evaluation reveals that this patient does indeed
complex decision-making (capacity for self-rule) and grants them the have appendicitis, and appropriate informed consent for surgical
ability to make choices without undue influence. Adolescent patients treatment is necessary. As has been explained, even if adolescents
are beginning to understand complex decision-making, but are they desire privacy and strive for autonomy, when a complex medical
capable of providing informed consent for medical procedures? decision is necessary, it is often not appropriate to allow them
Jean Piaget defines adolescence as a journey from concrete to make this decision on their own. This can be true even in
operational thought to formal logical reasoning. The ability to use cases relating to reproductive care. Guidance through a candid
formal logical reasoning allows an adolescent to weigh multiple discussion of worries and health risks may help adolescents
points of view and process more complicated questions. During incrementally assume responsibility while also helping them
this transitional period children are often dependent on their understand the need for parental involvement. In this instance,
parents socially and financially. Parents primarily make complex the patient ultimately shared his mother’s telephone number. The
decisions, including medical decisions, with some weight given ED staff was able to explain the situation to her in time for her to
to the adolescent’s opinion. There are several exceptions to this provide appropriate consent for the appendectomy. ◗
7
RESIDENT AND STUDENT
ADVISORY COMMITTEE
WHAT I WISH I KNEW IN that respect. I chose to leave the academic world and go into
community practice in Austin, Texas, as an employee of a
THE LAST FEW MONTHS private group, and making that decision opened up a ton of new
questions for me at that time. What was I supposed to do about
OF RESIDENCY
health insurance, taxes, malpractice, disability insurance? I was
fortunate in many ways, as my group provided me with malpractice
Steven J. Katz, MD and health insurance as well as a retirement fund, so those items
were immediately crossed off of my to-do lists.
So, where to start? This is a big topic, and by now you (hopefully)
The first, and, I thought, most important task was finding a place
have found a new job, signed contracts, found where you will be
to live. There are tons of options available – obviously, I am not
living for the next few months, and figured out which yacht you will
a financial expert, so I will not be able to give you advice about
be buying with your big new attending salary. Obviously, that last
mortgages or house-buying in general – but here’s what I have
bit was a joke, but in all seriousness, there are so many factors to
learned. We decided to rent for the first year because we knew
consider in the last few months of your life as a resident. It may
that a large proportion of EM physicians will change their jobs
seem overwhelming or even downright scary leaving your well-
after just one year. Plus, since we were anticipating a significant
known and comfortable world of residency, but you are about to
change in our collective income, we wanted to wait and search
embark on a great adventure.
for homes once we were more settled and I was sure I was going
I remember my first few shifts, and specifically the first patient
to stay at my job. There are many banks and lenders out there
I saw in my new and shiny community job. Prior to that day, I
that will see “MD” after your name and offer you more money than
had had multiple hours of computer training, orientation to the
you thought you would need for a home, ever. For the most part I
hospital system, etc., but there was something daunting about that
can say stay away from these options: they tend to have variable
first unsupervised shift. Unlike some of you, I did not choose to
rates, and you may end up paying a lot more than you want to
moonlight during residency, so my first day truly was my first shift
each month. Go with a trusted lender, and put 10-20% down on
on my own. My first patient was a 57-year-old male with shortness
a traditional mortgage. When you start the home-buying process,
of breath, and I thought, “Hey, I know how to take care of that!” and
talk to your family and other people who have done it before: they
entered my first patient room. That’s when things got interesting.
are a great resource of knowledge, and you can always learn from
The shortness of breath was actually respiratory distress with a
their mistakes.
severe CHF exacerbation that required multiple interventions and
Second was finding disability insurance, and this took the
eventually an ICU bed. That notwithstanding, I have felt comfortable
most amount of research and planning on my part. For most of
and well prepared for my new life as an attending.
you there will be an option to contact your residency-associated
I had my post-residency life semi-figured out by the last few
months, actually: I had signed my contract for my new job by
January of my last year, so I was slightly ahead of the curve in Continued on Page 9
8
include others outside of your institution or even outside emergency
medicine. For instance, one mentor I’ve frequently turned to over the
past year is a PhD in educational psychology at a university 2,000
miles away. Approach your mentorship as a symbiotic relationship in
which you must be an active member. In addition to receiving advice,
you must share your goals and knowledge gaps, and proactively
seek constructive feedback regularly.
Pick a focus and passion: You’ve made the decision to enter
academic medicine; now, what is your passion within the field?
Maybe you’ve entered academic medicine because you have a
passion for education. Now begin refining your focus: Is it medical
student education, resident education, procedural training or
bedside teaching? What are your ultimate goals? Do you want to
be clerkship director? A fellowship director? APD or PD? If you’re
entering a fellowship, you may have already started this process,
Continued from Page 8
but continue to refine your plan. Begin to create a vision for your
career and choose your experiences to align with your goals.
disability insurance carrier to continue your policy. Do it now if you
haven’t already. Yes, it’s expensive, but you want to be sure you Learn to say yes and no: As a fellow or attending, you’re finally
get specialty-specific coverage. What that means is if something gaining autonomy! Gone are duty hours! Gone are the Milestones!
happens and you can’t practice EM any more, the policy will Gone are the tedious requirements for residency completion!
provide you with whatever amount you pay for, even if you can do Unfortunately, this means your career is very much a choose-your-
other work. own-adventure novel. It is easy to say “yes” and quickly become
overwhelmed. There is always one more lecture series, one more
Last, plan out a budget. This is so important; I can’t stress this
research project, one more committee that could use your input, and
enough. I can hear you saying, But aren’t I going to finally have that
you may soon find yourself swamped with responsibilities. Saying
bank vault in my home like Scrooge McDuck, filled to the roof with
“no” is an art form. However, you must also avoid saying it too often
gold coins? No, I’m sorry to say, you won’t. I had the same thoughts
in your first year, as the opportunities may stop coming. Instead,
and, although my income has changed, a lot, there are so many
talk to your chair, your fellowship director, or your mentors early on,
things to begin saving and planning for that become important.
so they can both get you involved and assist you in tailoring your
Also remember that if you are an independent contractor, you will
activities. As you find your focus, you may need to politely decline
need to plan for expenses like taxes, malpractice insurance, and
projects that do not align with your ultimate career goals.
much, much more. If I can impart just one thing, let it be this: be
sensible with your new income, and enjoy the last few months of Academic balance: Remember, there are only so many hours
your time in residency. ◗ in the day, and numerous activities now competing for your time.
You will balance patient care, administrative tasks, service to the
hospital/ED, teaching, scholarly pursuits, and your own personal
and professional development. Some advice I wish I had known
ADVICE FOR NEW
sooner: break down the number of hours you plan to commit to
each item per week and month. If your goal is to be a clerkship
RESIDENCY GRADUATES
director, but research and scholarly activities account for 40%
of your time, you may need to revisit your priorities. How can you
Albert Kim, MD
shift your activities so the time spent better reflects your personal
Washington University in Saint Louis goals? Use this technique to aid you as you say “yes” or “no” to
available opportunities.
To my future colleagues in the wonderful field of emergency
medicine, congratulations! As of this writing, you are only a few Time management: Do you find yourself frequently running late?
short weeks from completing your residency training and pursuing Having trouble completing projects? Unlike in residency, there is
a career in academic medicine. As a recent graduate myself, I know no PD or residency coordinator to keep track of your requirements.
this is both an exciting and an intimidating experience. Juggling a “Oh, I forgot” or “I’ll turn it in next month” are no longer accepted.
new fellowship, a new position (Hello Dr. Attending, yes, you may One of my mentors encouraged me to utilize a scheduling program
get free coffee from the faculty lounge…), a new city or institution, (Outlook, Google Calendar, etc.) to both remind myself of deadlines
and new responsibilities can be quite overwhelming. I certainly am and allow time to work. Abstract due next week? Schedule a
not an expert, as I continue to struggle with many of these same four-hour meeting with yourself to write. Responding to emails is
issues. My goal is to share the best advice given to me over the necessary but time-consuming, so plan for a 30-minute session
past year by my own mentors and advisors, who have helped me each morning or afternoon. Maintaining realistic expectations of my
get through my first year post-residency. productivity has helped me stay on task with long-term projects
while avoiding the risk of taking on too much. Finally, remember
Find a mentor or mentors: There is no need to stumble through
you have passions outside the hospital that deserve your time
this alone. Find someone you trust to provide guidance and advice.
and attention. Don’t forget to schedule time with your family, your
This may be your fellowship director, former residency director, or
friends, time to run through the park, or to go see that new museum
any attending who is particularly supportive of your pursuits. Mentors
exhibit. Don’t allow yourself to burn out by ignoring the people and
should be individuals who understand your personal and professional
activities you love. ◗
goals, and have experience in these areas to share. This may
9
THE EVOLUTION
OF THE SAEM
SOCIAL MEDIA
COMMITTEE
Nicholas Genes, MD PhD Attendees had a new way to coordinate and learn what was
transpiring in other parts of the conference, and those who couldn’t
(@nickgenes)
make it could follow along from home. Growth was explosive, and
Icahn School of Medicine
engagement with so many members was rewarding and fun.
at Mount Sinai
After Phoenix, the Board of Directors tasked us with developing
Inaugural Chair,
guidelines for responsible social media use, for both the Twitter
SAEM Social Media Committee
“voice” of SAEM online (@SAEMonline), and for individual
Thinking back to five years ago, it may members looking to explore the new tools. We transformed into a
seem that we progressed, sure-footedly, full-fledged committee, with responsibilities to serve other groups
down a reasonable path - but at the time, within SAEM, and a goal of sponsoring didactic sessions at future
every decision felt like a gamble. Facebook Annual Meetings.
and Twitter were growing, sure - but there Delivering on those promises in Boston the following year was
was a sense they could quickly go the way tremendously satisfying. It also felt like it was time to pass the
of Friendster or MySpace, instead of maturing into the billion-dollar baton, and Jason Nomura took over as committee chair. While I
mainstays they are today. More important, many people regarded can marvel at what he and others have accomplished, and the
social media as a guilty pleasure or a frivolous distraction, unworthy new heights to which he’s taken this group, I’ll always be grateful
of investing resources or academic consideration. for the support of the SAEM staff, Board of Directors, Program
I had just finished residency and was in the midst of my Committee, and that early core group of Task Force members.
informatics fellowship when I saw SAEM’s call for members to join With their support and guidance, five years on, the Social Media
the “New Media Task Force.” While I was a member of the Society, Committee looks like a gamble that paid off.
and had even presented my journal club blog as an Innovation in
EM Education a few years prior, I had never really invested time
in an SAEM committee. But I was intrigued, and thought I could Jason T. Nomura, MD
help. I tried to submit my name for consideration through the (@takeokun)
SAEM website - but the task force was so new, and the website Christiana Care Health System
so dysfunctional, that there was no option for it in the drop-down Immediate Past Chair,
list. I emailed the president-elect at the time, Jeff Kline, directly, SAEM Social Media Committee
with some dashed-off ideas for what I thought I could contribute
Leading up to the 2012 meeting, the
to the task force.
Social Media Committee began to expand
Dr. Kline responded quickly, asking if I was interested in being
and grow. Completing one of the major
chair. He wanted to ramp up the Society’s social presence before
tasks set before it, the Committee finalized
the 2010 Annual Meeting, and felt I had the necessary credentials.
the Guidelines for the Use of Social Media
I was stunned, honored, but also a little skeptical. I didn’t know
for the SAEM membership policy, which
anyone in the SAEM leadership and would have to be working
was approved by the Board of Directors.
closely with staff, the Program Committee, and other chairs. He
This document was aimed at providing guidance about use of
promised to help with introductions and making connections, and
social media to the academies, committees, and task forces
with his support, we were off and running.
within SAEM and to SAEM as a whole.
The task force was able to recruit rising stars like Michelle Lin
The Committee members and staff worked hard to expand
(@M_Lin) and Jason Nomura, who were pioneering free, open-
SAEM’s social media footprint. Accounts had been started
access medical education before the #FOAMed term was coined.
and had grown on Twitter, Facebook, and Google+, along with
The SAEM staff – particularly Holly Gouin, Maryanne Greketis, and
collaboration with Academic Emergency Medicine on Vimeo.
Dave Kretz – were superb - always enthusiastic and open-minded
Expansion and growth of the Society’s social media profile began
(and patient). We quickly set up a presence on Facebook and Twitter,
with committee members posting information through the various
working with folks like Sandra Arjona at Academic Emergency
channels, with efforts from Nick Genes, Jason Nomura, and
Medicine to disseminate new research and engage with members.
Jim Miner (@jminer01). SAEM staff placed information about
When the 2010 Annual Meeting in Phoenix came around, we
the Social Media Committee and channels, along with calls for
were ready. Photos from the plenary session, opening reception,
content, in print and electronic publications.
dodgeball and other events were posted to Facebook. Key points
and comments from research sessions were shared over Twitter. Continued on Page 11
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