We must not condemn ABEM simply because that test is only for fresh residents who have nothing but supervised and sheltered training, and who don't require ATLS, ACLS or PALS.
BCEM on the other hand, requires a pre-existing board certification in either Family Practice or Internal Medicine PLUS 5 years fulltime unsupervised and fully responsible on-the-job training and experience (as well as their previous residency with deeper study of issues such as OBGYN or cardiogenic shock/critical care) PLUS ATLS, ACLS, PALS PLUS references from boarded docs (ABEM or BCEM), PLUS 10 case reports with discussions.
There is no superior board certification, just as there is no superior Cola or Baseball team or Religion. People with preferences will occasionally try to imply (or even bluntly state) that one or other board is inferior, but that is merely an attempt at restraining trade to their particular preference, and hence hope their pay will go up. It is also highly irresponsible to declare that one board is superior, since that creates an artificial shortage of emergency physicians, and hence wounds the public, by limiting their access to recognized physicians.
The Institute of Medicine (IOM) has declared in its 2006 reports on emergency care that board certification should never be a requirement for designation as an emergency physician. It is merely a merit badge, something to put on your CV to impress. The only requirements should be proof of competency in core knowledge and skills. Such core competency testing (already present in a minor format as ACLS, ATLS and PALS) will one day become the mainstay of emergency physician designation and employment requirements, and board certifications will still be respected, but not required, like winning an essay prize or academic competition or publishing a paper, but nothing more than that.
Being board certified does NOT prove you can intubate, place a thoracostomy tube or treat cardiogenic shock.
Please refer to the IOM website or that of the United States Alliance of Emergency Medicine for more information (
www.usaem.org).
TLW
