"Yes, this reflects the spirit of the original release."
Yes and no. The original release was a one-sided statement by ABEM. Prior to the posted new piece, there was no significant public acknowledgement by ABIM. The new piece includes acknowledgement by Holmboe speaking on behalf of ABIM. Also, the original release made no mention of a timetable for the first ABIM exam open to EM candidates.
"In fact, the phrases I've heard from a few fellowship directors out there (they must be reading this on the various list-servs) is that the whole plan is ‘unraveling'."
To exactly which unnamed fellowship directors would you be cryptically referring to? The directors of non-ACGME accredited EM-CCM fellowships? If they are posting to a public forum like email list serves, then let's be open about names instead of making unattributed statements.
I know for a fact that the IM RRC accredited CCM fellowship directors at Univ of Pittsburgh, Stanford, Cooper Hospital, St. John's Mercy/SLU (amongst other places) have already moved to begin considering EM applicants as part of their IM fellowship pools for ACGME reporting and tracking purposes. They are doing this because they anticipate that EM fellows will very soon count against their ACGME fellow allotments and in order to maintain ABIM board eligibility for these candidates.
"I think that by getting into bed with ABIM we risk having any progress on other fronts (like recognition from the ABS or via anesthesia) stopped cold."
This statement betrays a serious lack of historical perspective of this issue, and I mean decades of history. While I really wish that EM candidates could have continued access to great surgery programs (Shock Trauma) and anesthesia programs (Wash U, Hopkins, MGH, Brigham, etc.) while being able to obtain ABMS certification, this is not feasible. Historically, the ABA has engaged in talks with ABEM sporadically for years now. Do you know what we have to show for this? ABSOLUTELY NOTHING. Even as anesthesia CCM programs fell to fill rates of less than 50% due to declining anesthesia resident interest in CCM, the best the ABA offered was the distraction of combined EM/anesthesia residency programs. We do not need any more abortive compromises in the form of yet another combined residency program.
Politically, the ABS is even worse. Despite active recruitment of qualified EM candidates by Shock Trauma, who have thrived in their program, the issue of ABS certification for EM folks is dead in the water. The ABS is too conservative for this to happen, even with people from within Shock Trauma advocating on the behalf of EM. Furthermore, even within the world of surgical CC the struggle for a unified identity for surgical CC/trauma surgery/acute care surgery is overriding any attempts to throw EM into the mix. Despite years of trying, even trauma surgery remains without an ABS CAQ, largely due to the complex politics driving differences of opinion within the surgical CC versus other surgeons world. EM is not going to get anywhere with the ABS and they have made it clear that the issue is a non-starter for the foreseeable future.
I sincerely hope that the agreement with ABIM goes through, as I am tired of ABEM getting nowhere with ABA and ABS despite years of trying. Formal ABMS board recognition is needed in order to help the forward movement and development of EM-CCM. If ABIM is willing to play ball, then so be it. Pediatric emergency medicine is under the auspices of ABP and ABEM is a secondary co-sponsor. Sports medicine is under the administration of ABFM with ABEM as a co-sponsor. The proposed deal with ABIM is similar in principle.
"I urge ABEM to just go it alone and develop their own added CAQ or explain to the members why they can't (i.e. either substantiating or de-bunking the rumor that there is some ancient 'deal' in place preventing them from doing so)."
Even a cursory review of the history of this matter will demonstrate that ABEM has tried for years to obtain its own CAQ. I agree that having our own CAQ would be ideal, but it is simply not going to happen at this juncture. The "ancient deal" is a factual part of the history of EM (please refer to any of Brian Zink's publications on the matter). Decades ago, ABEM traded its pursuit of access to CCM in exchange for full board status and ABIM giving up its plan to develop a CAQ in emergency internal medicine. However, as the "deal" passed into remote history, ABEM renewed its attempts to obtain a CAQ only to be told there was no chance in hell. It is politically very difficult to obtain ABMS approval for an independent CAQ in a specialty that is already claimed by other boards. On the other hand, it is far easier to become a co-sponsor for an existing subspecialty.
Rome was not built in a day- even ABEM started out as a conjoint board under family medicine. It took years for ABEM to become a fully independent board. The evolution of EM-CCM in the United States is in its nascent stages. Co-sponsoring the ABIM CCM board is an appropriate route to obtaining formal ABMS recognition. The clear majority of adult intensivists in the US are boarded by the ABIM. Having access to 30-34 IM CCM fellowships would be a major step forward in our evolution. This story is just beginning.
"I, for one, will no longer be supporting ABEM until they at the very least release an official statement of where they stand on the issue."
This statement is utterly ridiculous given the years of effort put forth pursuing board access by multiple members of ABEM and deserves no further comment.
"My contribution and membership in ACEP and AAEM is also under scrutiny for the same reasons."
Both ACEP and AAEM have made statements on the issue of board access publically available for years. ACEP has even published periodic reaffirmations of its statement in support.
Again, I think that the ABIM board of directors vote this summer will lend some clarity. I, for one, am looking forward hopefully to the submission of an ABMS proposal.