Board Certification in EM

[qwerty1234]

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Ignorant MS4 question:

I understand the difference between ABEM and AAPS/BCEM - ie ABEM is the primary certifying agency for EM.

I thought that ABEM certification required training in an EM residency, but some of the programs I am looking at have faculty who completed residencies in other specialties. Despite this, the website says all faculty are ABEM certified.

My understanding was that you could not have one (ABEM certified) without the other (EM residency trained).

Could someone explain what I'm missing?

 

[deleted65604]

In my residency, all CLINICAL faculty were board certified by ABEM. (Required to have an ER residency)

One guy was an FP, who grandfathered in.

We had 2 doctors that were working in the ER prior to our residency starting that could no longer pull shifts there once there were residents training. Both now work at a free-standing ER that is staffed by the attendings in our residency and also work in the CDU, admitting patients for observation.

One of them gives us lectures on his niche, which is informatics, and sometimes other Internal Medicine topics.

There is also an ER doctor that is ER-trained, board-certified and does bench-top research on reperfusion injury and cardiac ischemia. Weird situation, but our ER department employs a PHD that participates in this research, but obviously, doesn't teach us in the department.

AAPS is not recognized by ER residencies.

 

[DeadCactus]

Ignorant MS4 question:

I understand the difference between ABEM and AAPS/BCEM - ie ABEM is the primary certifying agency for EM.

I thought that ABEM certification required training in an EM residency, but some of the programs I am looking at have faculty who completed residencies in other specialties. Despite this, the website says all faculty are ABEM certified.

My understanding was that you could not have one (ABEM certified) without the other (EM residency trained).

Could someone explain what I'm missing?

In the past, couldn't people in other specialties qualify for ABEM certification by spending enough time in the ED?

 

[EL CAPeeeTAN]

When the specialty was first forming its roots like many other specialties in the past there were no doctors board certified in "Emergency Medicine" as no board or residency existed. As the specialty matured there were many doctors from a variety of specialties who had been working in and build the specialty of emergency medicine. These physicians were granted the ability to grandfather into the emergency medicine specialty. I believe they were allowed to sit for board certification.

The timeframe to be grandfathered into the specialty no longer exists. You will run into doctors out there who were grandfathered into the specialty through their years of work in the emergency medicine although their residency was in a different specialty.

There are many on this board with greater knowledge who will chime in if I have missed something on this subject.

Here are some of the details:

The ABEM exam was first offered in 1980. From 1980 to 1988, there were two ways for physicians to qualify for the examination. One could either complete a residency in emergency medicine, or satisfy the requirements of a "practice track" pathway. The prerequisites of this option were 7,000 hours and 60 months of emergency department practice experience, with a specified number of CME credits in emergency medicine.
In 1988, this alternative pathway was terminated.

 

[southerndoc]

AAPS/BCEM is only recognized by the State of Florida if memory serves me correctly. ABEM is the official ABMS-sponsored certifying organization for emergency medicine and is the one hospitals usually require for emergency physicians to maintain privileges.

 

[NateintheED]

AAPS/BCEM is only recognized by the State of Florida if memory serves me correctly. ABEM is the official ABMS-sponsored certifying organization for emergency medicine and is the one hospitals usually require for emergency physicians to maintain privileges.

In the last couple months Texas has also chosen to recognize AAPS/BCEM and allow those docs to advertise themselves as "board certified" in Emergency Medicine. ACEP recently published a press release/position statement condemning this decision. This statement from ACEP has been met with some backlash from the EM community, primarily those trained in other specialties but who practice in the ED, since there aren't enough residency-trained, ABEM-certified EP's to go around, especially in small places.

You can read ACEP's statement at thecentralline.org, as well as some of the responses by individuals (about 40 when I read it the other day).

 

[Jeff698]

In the last couple months Texas has also chosen to recognize AAPS/BCEM and allow those docs to advertise themselves as "board certified" in Emergency Medicine.

As a proud Texan, I proclaim this "not one of my prouder moments".

While I'm very grateful for those who came before me professionally (and readily acknowledge them as my EP brethren, neigh forefathers, and heartily recognize their hard earned certification), mindful that they by necessity trained in other specialties, the path forward now clearly requires EM residency training for EM certification.

ABEM requires this, BCEM doesn't. ABEM is the real deal (ABMS etc), BCEM is an attempt to turn back the clock and circumvent a needed progression in the life of our profession.

Not that I feel strongly about it or anything.

Take care,
Jeff

 

[old_boy]

ABEM requires this, BCEM doesn't. ABEM is the real deal (ABMS etc), BCEM is an attempt to turn back the clock and circumvent a needed progression in the life of our profession.

Question:
As a 3rd med student considering emergency medicine as a career, is this something I really need to worry about, or is it more of a pride thing? It seems there are sounds of a major turf battle brewing on a national scale in the posts below the ACEP press release here: http://thecentralline.org/?p=972&cpage=1#comments

Please tell me I'm wrong.

 

[Jeff698]

Question:
As a 3rd med student considering emergency medicine as a career, is this something I really need to worry about, or is it more of a pride thing?

It's more than a pride thing BUT, as a MSIII, you have much more important things (and quite a few less important) things to worry about.

I'd recommend following the discussion to stay informed and to develop your own opinions about it but don't let this dissuade your from choosing EM if EM is what you want.

Take care,
Jeff

 

[Haemr Head]

BCEM --> Did not want to go through an EM residency, could not get into an EM residency, or failed at something else and now wants to get paid as an EM physician without the training --> Why would I hire this person into my group when the ABEM stamp ensures me that I can get someone who is actually trained for the work?

If you want to do EM, then do a residency, because it is the right thing to do AND it provides job security.

 

[docB]

BCEM --> Did not want to go through an EM residency, could not get into an EM residency, or failed at something else and now wants to get paid as an EM physician without the training --> Why would I hire this person into my group when the ABEM stamp ensures me that I can get someone who is actually trained for the work?

This is a good question. Why do docs and EM physician groups want a loophole instead of just getting the training? There is the issue of docs who want to move into EM from other specialties and getting the training is inconvenient/impossible due to time and financial issues. I feel that for them to try to do this and to expect parity shows a deep disrespect toward the training and the specialty.

There is also the issue of groups that have employed non boarded docs for years, since before being boarded mattered as much, and now that board certification is becomming a requirement they want to keep them on. The answer to that issue is to create a specific exemption in the contract for those docs, not to create some bastardized, back door board.

 

[roja]

I imagine that this will be solved after a few malpractice suits and lawyers winning by bringing (appropriately) residency training and ABEM certification.

 

[Haemr Head]

I imagine that this will be solved after a few malpractice suits and lawyers winning by bringing (appropriately) residency training and ABEM certification.

The problem is that these guys are subcontracted by a hospital or the ED contract holder. When the lawsuit happens, the BCEM provider is legally toast but the person or institution that profited from the cheap labor is rarely targeted and just puts a new cheap player on the field. Because of this, it takes a long time for institutions to realize that the emergency department is not a good place to run amateur hour.
On the other hand, most of the people who get BCEM certificats will work at small volume EDs that can't afford ABEM providers and that's just the way the market works. I just find that handing out certificats without training or standards is offensive and belittles our specialty. I don't see anyone trying this out (yet) in neurosurgery.

 

[southerndoc]

I read X-rays and EKG's. Maybe we should get a secondary board to offer us testing in cardiology and radiology.

That's how I think of the backdoor approach to emergency medicine.

 

[Jeff698]

I agree with Southern...

We drain abscesses. Does this make me a surgeon?

We deliver baby's and do lots of pelvics..... OB/GYN certification.

We reduce fractures... ortho certification.

We treat kids... pediatric certification.

We treat adults... internal medicine certification?

I'm sure we could come up with a test that we could all pass and then call ourselves board certified in all of these specialties.

Makes about as much sense as BCEM.

Take care,
Jeff