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Academic Career Guide I Chapters 18 Summary

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Title: Academic Career Guide I Chapters 18 Summary


1
Academic Career Guide I (Chapters 1-8 Summary)
2
The History of Academic Emergency Medicine
Milestones
  • 1960-70s Emergency Department regarded as a
    pita place to start, end, or be exiled if you
    were impaired or incompetent
  • Patient pressures (volumes, expectations),
    lessons in trauma care from major wars, and
    recognition of highway injuries spurred the need
    for better training for Emergency Physicians
    (EPs)
  • 1968- Beginning of American College of Emergency
    Physicians (ACEP)
  • 1969- First Scientific Assembly in Denver,
    Colorado

-Summarized from G. Hamilton, SAEM ACG Chapter 1,
2007
3
The History of Academic Emergency Medicine
Milestones
  • 1970s The first residencies Cincinnati, Penn,
    USC, Chicago, Louisville
  • 1972 AMA rejects 1st proposal for Residency
    training in emergency medicine
  • 1973 ACEP creates their own approval process
    with ACEP Graduate Education Committee
  • 1972 publication of EMs first journal, Journal
    of the American College of Emergency Physicians
    (JACEP)

-Summarized from G. Hamilton, SAEM ACG Chapter 1,
2007
4
The History of Academic Emergency Medicine
Milestones
  • 1974 formation of Emergency Medicine Residents
    Association (EMRA)with growing numbers of
    residents
  • Society of Teachers of Emergency Medicine (STEM)
    created through ACEP, a first vital link to
    American Association of Medical Colleges
  • 1975 AMA approves a permanent Section of
    Emergency Medicine and standards for EM
    residencies

-Summarized from G. Hamilton, SAEM ACG Chapter 1,
2007
5
Academics vs. Community Practice?What is
Academic Practice?
  • Keystones Clinical Practice, Teaching, and
    Research
  • ABEM academician is practitioner who spends 40
    of their time outside of clinical duties
    (writing, teaching, research)usually with
    protected time for these pursuits.
  • -tenure track positions often have requirements
    for research funding, publications, and
    scholarly work.
  • Generally associated with a teaching hospital and
    core faculty at EM residency programs

-Summarized from LC Patten and F Ankel, SAEM ACG
Chapter 2, 2007
6
Academics vs. Community Practice?Early Paths to
Academics
  • Get involved in research many academic careers
    will require work in research, so residents may
    be well served to learn the fundamentals of
    research funding, proposals, writing early
  • Find a mentor get key advice for academicians
    who have paved their way before you
  • Fellowships academics highly values training
    beyond the usual EM residency. Possibilities
    include toxicology, pediatric emergency, sports
    medicine, ultrasound, pre-hospital care,
    education, research

-Summarized from LC Patten and F Ankel, SAEM ACG
Chapter 2, 2007
7
Academics vs. Community Practice?What is
Community Practice?
  • ABEM community practitioners spend more than 50
    of their time on clinical duties
  • Other duties often include administration or
    quality improvement
  • Residents not training in community-hospital
    based residencies who are considering community
    practice should do elective rotations at a
    community hospital to evaluate this practice type
    first hand
  • Community practitioners are good resources for
    residents who wish to explore community practice

-Summarized from LC Patten and F Ankel, SAEM ACG
Chapter 2, 2007
8
Choosing AcademicsHow to Plan Your Residency
  • The foundations of success in academics are
    excellence in both clinical EM and scholarly
    activities
  • Success in academics is possible from 3 and 4
    year programs (any sticking points resolve after
    1 year of practice or fellowship)
  • Requisite tools for academics to develop
    clinical, teaching, research, writing,
    administrative, and people skills
  • Participation in national organizations (EMRA,
    ACEP, AAEM, SAEM) provide opportunities for
    mentorship, networking and collaboration

-Summarized from J Davis JL Oakes, SAEM ACG
Chapter 3, 2007
9
Choosing Academics pros/cons of different paths
  • Chief Resident
  • pros- valuable experience with administrative
    duties, policy making, quality improvement,
    teaching, advocacy
  • cons- depending on format an additional year
    before fellowship or entering workforce or
    additional rigor to senior year
  • Graduate degrees
  • pros- creates focus and expertise for future work
  • cons- additional time and financial commitment.
  • Fellowship (see also the next section)
  • pros- create a precious niche within academic
    emergency medicine
  • cons- additional training time and delayed
    workforce entry and financial rewards

-Summarized from J Davis JL Oakes, SAEM ACG
Chapter 3, 2007
10
Importance of a Fellowship Jump Start Your
Academic Career
  • Check Fellowship section of www.saem.org for
    details
  • Why? Identify and develop a niche within
    emergency medicine
  • -Pursue specific interests and skill sets
  • -Mentorship for developing academicians
  • -Some include additional degrees (MBA, MPH, MS)
  • -ACGME board certification (only available for
    some types of fellowships Hyperbaric, Pediatric
    EM, Sports medicine, Toxicology, Hospice)
  • Why Not? 1-3 year delay in larger salary and
    likely worse work schedule

-Summarized from DS Howes, SAEM ACG Chapter 4,
2007
11
Importance of a Fellowship What are the Choices?
  • Medical Education/Faculty Development work
    clinical shifts in academic center, while also
    protected time for didactic teaching, research,
    often also opportunities for Masters degree in
    education
  • Administration exposure to operational workings
    in ED and hospital. May include graduate work
    towards MBA or MPA degree
  • Critical Care currently EM physicians cannot
    become board certified. However EM physicians
    can utilize these skills/training in practice and
    some serve as medical directors of ICUs despite
    lack of board certification

-Summarized from DS Howes, SAEM ACG Chapter 4,
2007
12
Importance of a Fellowship What are the Choices?
  • Emergency Medical Services (EMS) further
    experience with pre-hospital emergency care and
    EMS system. Fellows often serve as medical
    director (or assistant director) for local EMS
    systems
  • Hyperbaric Medicine hyperbaric physiology and
    diving medicine. Applications include
    decompression sickness, non-healing wounds,
    infections, carbon monoxide poisoning, others
  • International Emergency Medicine evaluate
    emergency health needs in countries lacking EMS
    systems. Often requires international travel and
    MPH degree

-Summarized from DS Howes, SAEM ACG Chapter 4,
2007
13
Importance of a Fellowship What are the Choices?
  • Pediatric Emergency Medicine training taking
    care of pediatric patients, mainly in ED but also
    with ICU and subspecialty exposure. Usually
    incorporates protected research and teaching time
  • Hospice and Palliative Care new in 2007,
    training programs still being developed
  • Sports Medicine non-operative management of
    musculoskeletal sports conditions. Not all
    programs accept EM physicians

-Summarized from DS Howes, SAEM ACG Chapter 4,
2007
14
Importance of a Fellowship What are the Choices?
  • Toxicology biochemistry, pharmacology, and toxic
    effects of pharmaceutical and environmental
    compounds. Often includes opportunities to work
    with poison control centers.
  • Ultrasound many applications, including
    experimental. Also involved in credentialing
    /teaching others to use EM ultrasound
  • Others (see SAEM website) forensics, medical
    informatics, disaster research and management,
    geriatrics, neurological and cardiovascular
    emergencies

-Summarized from DS Howes, SAEM ACG Chapter 4,
2007
15
The Academic Skill Set
  • More than I like to teach residents, though
    this is important
  • A Career in academic EM entails deliberate plans
    aimed at acquiring skills, achieving milestones,
    and building achievements
  • Beyond teaching.
  • -Lecture and Presentation skills addressing
    specific learners needs, computers skills
  • -Effective communication skills may be developed
    by participation in academic tasks in residency
  • -Critical reading and writing skills essential
    in teaching, research and admin positions

- Summarized from M Dorfsman, SAEM ACG Chapter 5,
2007
16
The Academic Skill Set
  • Beyond teaching.(continued)
  • -Research nearly all academic EPs are required
    to engage in some sort of research
  • -Getting involved in a basic, simple research
    project early in residency or an academic career
    provides experience with Institutional Review
    Boards, statistical methodology, analysis,
    academic reading/writing, peer reviews, and
    oral/poster presentations
  • Bottom Line jump on opportunities to teach, do
    research, and get administrative experience!

- Summarized from M Dorfsman, SAEM ACG Chapter 5,
2007
17
Creating a Healthy Career Wellness
  • Wellnesswhat does it mean to you? Realize
    this meaning may change during different stages
    in your professional life
  • Long-term wellness isnt just the absence of
    unhealthy feelings or burnout, but it is the
    active involvement in things that rejuvenate you
    such as family, friendships, hobbies,
    spirituality, and exercise

-Summarized from F. Nobay, SAEM ACG Chapter 6,
2007
18
Creating a Healthy Career Wellness
  • Challenges to Wellness in Emergency Medicine
  • -Witness tragedy, violence, and illness daily
  • -Shift work (and impact on sleep)
  • -Youth of EM specialty in the hospital hierarchy
  • -Lack of time to rest, socialize, eat optimally
    during work
  • -Isolation from social support due to geographic
    and scheduling constraints
  • -Loss of camaraderie resulting from shift work
  • -Briefness of relationships with patients
  • -Difficult interactions with ED staff

-Summarized from F. Nobay, SAEM ACG Chapter 6,
2007
19
Creating a Healthy Career Balancing Personal and
Professional Responsibilities
  • Create a long-term vision of your life helps
    ensure that your arent overwhelmed by tumult of
    the moment
  • Connect to colleagues get to know co-workers as
    people, not just other staff. Connection creates
    intimacy of our experience
  • Enjoy what you do at least some of the time.
    Find humor and laughter in your work
  • Physical well being exercise, sleep hygiene and
    protection, good nutrition and hydration
  • Keep in touch with family, friends to stay
    connected with life outside of medicine and find
    support. Especially with immediate family. Find
    ways to be present for important life events
    (birthdays, graduation, etc.)

-Summarized from F. Nobay, SAEM ACG Chapter 6,
2007
20
Creating a Healthy Career Time Management
  • Make plans create things to look forward to
    anything from lounging in front of TV, to exotic
    trips
  • Take time for yourself 5 minutes? A weekend? You
    must have ways to refuel the energy it takes to
    be an EP
  • Be realistic You wont have time to do
    everything you want to and still get adequate
    sleep. Avoid over-extending your schedule
  • Invest in a time management tool PDA? Home
    calendar? Choose one method that works for you
    and your family to interconnect your life

-Summarized from F. Nobay, SAEM ACG Chapter 6,
2007
21
Creating a Healthy Career Avoiding Burnout
  • Syndrome of emotional exhaustion,
    depersonalization and a sense of low personal
    accomplishment that leads to ineffectiveness at
    work
  • Manifestations Loss of interest in work, fear,
    avoidance, anger, loathing, fatigue,
    irritability, headache, malaise, anxiety, broken
    relationships, disillusionment
  • Red Flag if youre asked about burnout by more
    than 1-2 peoplestart looking for
    resources/support. Watch out for exacerbation of
    psychiatric illness or substance abuse
  • Unique stressors for Women EPs called something
    other than doctordifferent expectations by
    staffbalancing work with motherhood. Try
    finding a mentor, set realistic expectations for
    yourself, and set limits/ say no

-Summarized from F. Nobay, SAEM ACG Chapter 6,
2007
22
Teaching and Education Academics as a Clinical
Educator
  • Key topics
  • -Areas to focus teaching excellence
  • -Identify faculty development opportunities,
    mentor relationships
  • -How to achieve promotion and tenure in a
    teaching-based academic career

-Summarized from CS Weaver and AJ Callisto, SAEM
ACG Chapter 7, 2007
23
Teaching and Education Academics as a Clinical
Educator
  • Areas to focus teaching
  • -In the ED great venue for bedside teaching and
    learning bites. Teach to your audience
    (student? resident? RN? medic?)
  • -Graduate Medical Education didactics,
    mentorship, career advice, direct resident
    supervision
  • -Education Research peer-reviewed publications,
    book chapters, grant funding, advancement of
    medical education and discovery/validation of
    learning products

-Summarized from CS Weaver and AJ Callisto, SAEM
ACG Chapter 7, 2007
24
Teaching and Education Academics as a Clinical
Educator
  • Faculty Development Becoming an Accomplished
    Teacher
  • - National/local faculty development programs
  • - Advanced Education degrees credibility in
    academics, opportunities to collaborate w/ other
    graduate staff
  • Having a mentor, successful as a
    clinician-educator is felt to have one of the
    most positive influences on career development

-Summarized from CS Weaver and AJ Callisto, SAEM
ACG Chapter 7, 2007
25
Teaching and Education Academics as a Clinical
Educator
  • Promotion and Tenure what does your institution
    offer?
  • -dual track? clinical track vs. tenure track?.
    The key is understanding what your institutions
    criteria are, if the overall mission of the
    institution values clinical teaching (with
    promotion tracks that reflect this value)key
    issues in your job search
  • -documentation keeping evidence of everything
    educational endeavors, teaching evaluations,
    awards, evidence of quality advising.promotion
    committees are interest in this evidence of
    achievement and expertise

-Summarized from CS Weaver and AJ Callisto, SAEM
ACG Chapter 7, 2007
26
Medical Student Educator Pathway Teaching within
the Curriculum
  • First Year Students Basic first aid,
    fundamentals of EMS systems and triage, ethics of
    emergency care, introducing the patient interview
    and physical exam
  • Second Year Students emphasizing pathophysiology
    and pharmacology shock, drug abuse, toxicology
    case studies can be integrated into core science
    material
  • - also a time to tutor/participate in small
    group learning, skills laboratories, and
    observational ED rotations

-Summarized from G Schmitz and C Hobgood, SAEM
ACG Chapter 8, 2007
27
Medical Student Educator Pathway Teaching within
the Curriculum
  • Third Year Students ideally dedicated 4-8 week
    ED rotations with focused core competencies and
    very basic procedures. Key opportunities for
    educators to directly supervise student clinical
    activity and teach
  • Fourth Year Students clinical rotation vs.
    sub-internships.
  • - didactic program emphasizing problem based
    management
  • - procedural didactics/labs suturing,
    splinting, IV access, airway and resuscitation.
    Focus on recognizing life-threatening conditions
  • - ideally multiple formats bedside, skills
    labs, simulation courses

-Summarized from G Schmitz and C Hobgood, SAEM
ACG Chapter 8, 2007
28
Medical Student Educator Pathway Student
Contact outside the Curriculum
  • Career Advisor critical to raise awareness of EM
    as a career choice and contribute to general
    welfare of students
  • Mentoring take an active role in students
    future and career development, especially key for
    women and underrepresented minorities in academic
    medicine
  • Interest Group Advisor broad exposure for
    interested students
  • Clinical Research get a student involved in your
    research!
  • Journal Club Advisor teach clinical concepts and
    critical literature review and evidenced based
    medicine

-Summarized from G Schmitz and C Hobgood, SAEM
ACG Chapter 8, 2007
29
Author Credit Acad Career Guide IE. Willis
Nottingham MD
  • Questions

30
Postresidency Tools of the Trade CD
  • 13) Negotiation Ramundo
  • 14) ABEM Certifications Cheng
  • 15) Patient Satisfaction Cheng
  • 16) Billing, Coding Documenting Cheng/Hall
  • 17) Financial Planning Hevia
  • 18) Time Management Promes
  • 19) Balancing Work Family Promes Datner
  • 20) Physician Wellness Burnout Conrad /Wadman
  • 21) Professionalism Fredrick
  • 22) Cases for professionalism ethics SAEM
  • 23) Medical Directorship Proctor
  • 24) Academic Career Guide Chapter 1-8
    Nottingham
  • 25) Academic career Guide Chapter 9-16 Noeller
  • 1) Career Planning Garmel
  • 2) Careers in Academic EM Sokolove
  • 3) Private Practice Career Options - Holliman
  • 4) Fellowship/EM Organizations Coates/Cheng
  • 5) CV Garmel
  • 6) Interviewing Garmel
  • 7) Contracts for Emergency Physicians Franks
  • 8) Salary Benefits Hevia
  • 9) Malpractice Derse/Cheng
  • 10) Clinical Teaching in the ED Wald
  • 11) Teaching Tips Ankel
  • 12) Mentoring - Ramundo
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