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The International Federation for Emergency Medicine : Its Role in Developing E.M. Training Programs Globally


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Title: The International Federation for Emergency Medicine : Its Role in Developing E.M. Training Programs Globally

The International Federation for Emergency
Medicine Its Role in Developing E.M. Training
Programs Globally
Jim Holliman, M.D., F.A.C.E.P., F.I.F.E.M.
President, International Federation for
Emergency Medicine Professor of
Military and Emergency Medicine Uniformed
Services University of the Health Sciences
Bethesda, Maryland, U.S.A.
Professor of Emergency Medicine Penn
State University, Hershey, PA, U.S.A.

The International Federation for Emergency
Medicine (IFEM) Its Role in Developing E.M.
Training Lecture Goals
  • Present background information on the history and
    current structure of IFEM
  • Present the current resources IFEM has developed
    for Emergency Medicine (E.M.) training
  • Present proposed additional activities for IFEM
    to undertake
  • Encourage participation in IFEM activities and

Origins of IFEM
  • Started in the late 1980s as a consortium
    between the British Association of Accident and
    Emergency Medicine (BAEM), the American College
    of Emergency Physicians (ACEP), the Canadian
    Association of Emergency Physicians (CAEP), and
    the Australasian College of Emergency Medicine
    (ACEM) (representing Australia and New Zealand)
  • Its original main activity was just conducting
    the International Conference on Emergency
    Medicine (ICEM) every 2 years
  • First ICEM held in London, United Kingdom (U.K.)
  • In 1986

Early History of IFEMs ICEM
  • The IFEM founding organizations agreed to rotate
    the location of the ICEM every two years in the
    sequence United Kingdom, Australia, Canada,
    United States, and then repeat the cycle
  • The host country national EM organization was
    responsible for organizing the ICEM in its
  • The IFEM Presidency rotated to the President of
    the current ICEM host country EM organization

Change in Philosophy for IFEM
  • In the mid 1990s the IFEM leadership decided to
    open up membership in the IFEM to other
    countries EM organizations (in addition to the
    original 4 Founding Member Organizations)
  • Later it was decided that any IFEM member
    organization could apply to host the ICEM (so it
    would not just continue to rotate between the
    original 4 Founding Member countries)
  • First ICEM held outside the original 4
    countries was in Singapore in 2010

Categories of Membership in IFEM
  • Founding Members BAEM (now the College of
    Emergency Medicine (UK) ), ACEP, CAEP, ACEM
  • Full Members EM organizations which are the
    leading national EM organization in a country
    which recognizes EM as a specialty and has at
    least one EM specialist training program
  • Affiliate Members Other national EM
    organizations in a country already represented by
    a Founding or Full Member or in a country where
    EM is not recognized or no residency training
    programs yet exist
  • Ex-officio Members other multinational or
  • EM organizations

Note that Affiliate and Ex-officio Members do not
have voting privileges
IFEMs Early Years Structure
  • IFEM President was the President of the host
    country organization for the ICEM
  • Board of Directors (BOD) members were the
    Presidents of the Founding and Full Members
  • The IFEM Executive (acting as a leadership
    committee) positions were elected from the BOD
    members (Secretary, Treasurer, Member at Large)
  • BOD meetings were held at ACEPs Annual
    Scientific Assembly and at each ICEM

Further Changes in IFEMs Philosophy and
  • In the 2000s the IFEM leadership decided the
    organization should do more than just operate the
    ICEM and should become more of a service
    organization and undertake major activities to
    assist its members and other countries which do
    not yet have good EM services with EM and EMS
  • The general goal was for IFEM to become the
    worlds premier organization for EM development
    and promotion

Background for IFEMs Recent Structural Changes
  • As the number of members of IFEM grew to more
    than 30, the BOD meetings became unwieldy and
    there was a feeling that there should be more
    regional representation and input at the
    Executive level in IFEM
  • Also as IFEM developed sources of revenue and
    complexity of operations it was felt necessary to
    incorporate the organization
  • So starting in 2005 a multi-year Bylaws revision
    process was undertaken
  • New tripartite structure took effect in 2012

Current IFEM Three Level Structure
  • Executive President, President-Elect or
    Past-President, Vice-President, Treasurer,
    Secretary, Member at Large (representative from
    the Planning Committee for the next ICEM)
  • BOD all the members of the Executive plus 6
    regional representatives (Africa, Asia,
    Australasia, Central / South America, Europe,
    North America)
  • Assembly Representatives from the Founding,
    Full, Affiliate, and Ex-officio members (now
    total gt 60)
  • Executive and BOD have periodic phone conferences
    and all 3 levels have face to face meetings at
    the ICEM and ACEPs Annual Scientific Assembly

Should IFEM Have Individual Members ?
  • This has been extensively debated by the IFEM
  • Idea behind this would be to have IFEM membership
    be available to EM physicians in countries that
    dont yet have an EM organization
  • But it was decided that having individual
    memberships might decrease participation in
    national EM organizations
  • Individuals can currently be represented in IFEM
    through the Ex-officio regional society members
    of IFEM (the Latin American, African, Asian, and
    European Societies)

IFEMs Designation of Committees to Carry Out EM
Development Efforts
  • Finance
  • Governance
  • Core Curriculum and Education
  • Clinical Practice
  • Specialty Implementation
  • Continuing Professional Development
  • Research
  • ICEM Site Selection Sub-committee

IFEMs Designation of Task Forces and Special
Interest Groups to Carry Out Focused EM
Development Efforts
  • Standard Terminology Task Force
  • Access and Availability Task Force
  • Global EM History Book Project
  • Disaster Medicine Special Interest Group
  • Pediatric Standards Special Interest Group
  • Ultrasound Special Interest Group
  • Triage Special Interest Group
  • Gender Issues Task Force
  • Sustainability Task Force
  • Communications Task Force
  • (proposed) International Residents Association

Activities of the IFEM Finance Committee
  • Monitor and report income (IFEMs main income is
    from a per capita fee for each attendee at the
    ICEM and from membership dues)
  • Maintain and dispense IFEM funds from a bank
    account in Australia
  • Develop new sources of income for IFEM

Activities of the IFEM Governance Committee
  • Much of the work of this committee was completed
    in 2012 with the institution of the new Bylaws
    structure for IFEM
  • Provides ongoing review of the IFEM Bylaws and
    maintains consistency of wording between the IFEM
    Bylaws and the IFEM Constitution (for reasons of
    convenience and finances, IFEM has been
    registered and incorporated in Australia)

Activities of the IFEM Core Curriculum and
Education Committee
  • Published in multiple journals a standardized
    international curriculum for medical student
    training in EM and a curriculum for residency
    training in EM
  • Is working on writing a standardized
    international curriculum for paramedic training
  • Has submitted for publication a standardized
    curriculum for continuing professional
    development for EM physicians in practice
  • Has prepared a manuscript on Mapping the EM
    Curriculum to Assessment Methods
  • Collaborating with the U.K. College of EM on its
    ENLIGHTENME virtual learning resource

(No Transcript)
IFEMs Medical Student Curriculum Published on
the IFEM Web Site
International Federation for Emergency Medicine
Hobgood, MD,1 Venkataraman Anantharaman,MD,2 Glen
Bandiera, MD,3 Peter Cameron, MD,4 Pinchas
Halperin, MD,5 Nicholas Jouriles, MD,6 Darren
Kilroy, MD,7 Terrence Mulligan, MD,8 Andrew
Singer, MD,9 for the International Federation for
Emergency Medicine Cherri Hobgood, University of
North Carolina School of Medicine, Chapel Hill,
NC, USA 2Venkataraman Anantharaman, Singapore
General Hospital, Singapore, Singapore 3Glen
Bandiera, University of Toronto, Toronto, ON,
Canada 4Peter Cameron, MD 5Pinchas Halperin,
Tel Aviv Medical Center, Tel Aviv, Israel
6Nicholas Jouriles, Akron General Medical
Center, Akron, Ohio, USA 7Darren Kilroy, College
of Emergency Medicine, London, United Kingdom
8Terrence Mulligan, Erasmus University School of
Medicine, Rotterdam, The Netherlands 9Andrew
Singer, Canberra Hospital, Woden, Australia
Associate Professor, Associate Chair, Department
of Emergency Medicine, UNC School of Medicine, CB
7594, UNC Hospitals, Chapel Hill, NC 27599
919-966-6442 RUNNING HEAD
IFEM Model Curriculum KEY WORDS curriculum,
international emergency medicine, medical
education, WORD COUNT 2372 IFEM UGE
IFEMs Postgraduate (C.P.D.) Curriculum
  • IFEM Model Curriculum for Continuing
    Professional Development, Hobgood C et al.,
    submitted to the Canadian Journal of EM (CJEM)
    June 2014.

Activities of the IFEM Clinical Practice Committee
  • Its Pediatric Standards Special Interest Group
    produced the widely acclaimed document
    International Standards of Care for Children
    which is on the IFEM web site
  • Its Ultrasound Special Interest Group developed a
    standardized international curriculum for point
    of care ultrasound training which has been
    submitted to CJEM for publication
  • Partnering with the Guidelines International
    Network to make more international clinical care
    guidelines openly available
  • Endorsed collaborative activities connected with
    World Sepsis Day
  • Cooperating with the Specialty Implementation
    Committee in accumulating and posting on line web

Activities of the IFEM Specialty Implementation
  • Conducted a Needs and Resources Assessment survey
    of the IFEM membership
  • Has posted a number of open access lectures as
    references on the IFEM web site
  • Is collaborating with the Clinical Practice
    Committee to accumulate, categorize, and post a
    listing of useful EM web sites on the IFEM web
  • Has submitted for publication a manuscript on
    How to Start and Operate a National EM Specialty

Activities of the IFEM Continuing Professional
Development Committee
  • Supervises the ICEM Site Selection Sub-committee
  • Updated the IFEM Guidelines on operation of the
    ICEM, and on operation of IFEM endorsed
    satellite symposia, and on IFEM endorsement of
    other EM conferences
  • Collaborating with the Core Curriculum Committee
    on the Standardized Recommendations for
    Post-graduate CPD manuscript

Activities of the IFEM Research Committee
  • Decided that IFEM should not formally affiliate
    with any existing EM journal at this time
  • Is working on identifying research content
    experts and their areas of research expertise by
    country, and on identifying current research
  • Developing criteria for handing requests for
    research network endorsements
  • Identifying current educational modules on
    research techniques which could be made openly
    available on-line
  • Published a statement on ethical standards

Activities of the IFEM Site Selection for the
ICEM Sub-committee
  • Review the applications by different IFEM member
    organizations to host an upcoming ICEM
  • Has sub-committee members from the planning
    committees for the last and the next ICEM
  • Assesses the strengths of each application
    relative to the scientific and educational
    content of the proposed program, the tourism
    attractiveness of the proposed venue, and the
    ability of the hosting organization to have the
    financial and personnel resources to conduct the

Activities of the IFEM Standard Terminology Task
  • Has conducted a multiple round survey of the IFEM
    membership on EM terminology and achieved a high
    degree of agreement on the definitions of key
    terms in EM
  • Submitted a manuscript of the definitions list to
    Annals of EM July 2014

Activities of the IFEM Access and Availability
Task Force
  • Conducted an international pilot survey on the
    degree of access to EM services in different
    countries and is developing a journal manuscript
    with the survey results
  • Is working on developing sources of funding for
    larger studies of EM access and availability
  • One of the Task Force members, Dr. Gautam
    Bodiwala of the U.K., has served as IFEMs
    representative to the World Health Organizations
    Trauma Care Committee

Activities of the IFEM Global EM History Book
  • Decided on a general content and preliminary
    chapter list for a book on the history of EM
  • Is identifying specific persons to author
    chapters in the book (many of the chapters are
    about the history of EM development in single

Activities of the IFEM Disaster Medicine Special
Interest Group
  • Collaborate with the World Association of
    Disaster and Emergency Medicine and other
    disaster-related organizations in developing
    disaster management training resources and in
    participating in international conferences
  • Develop presentations on disaster management for
    the upcoming ICEMs
  • Serve as an information resource on disaster
    management for IFEM members
  • Accumulate educational resources on disaster
    management for IFEMs web site

The IFEM Framework for Quality and Safety in the
Emergency Department
  • Is a highly regarded consensus document outlining
    the key components of safe, high quality care in
    the Emergency Department
  • Produced from the Proceedings of the IFEM
    Quality and Safety in Emergency Care Symposium
    held in the U.K. in November 2011
  • Reviewed in a plenary session at the ICEM in
    Dublin, Ireland in June 2012

IFEMs Current Office Structure
  • IFEM Secretariat is located in ACEMs office in
    Melbourne, Australia
  • ACEM provides office and one half time employee
    staff support
  • IFEM is incorporated and registered under
    Australian law, but effectively is independent of
  • ACEP provides committee operation support and
    CAEP may also do this

IFEMs Current Officers of the Executive
  • Executive Officer Carol Reardon
  • President Dr. Jim Holliman (ACEP)
  • President-elect Dr. Lee Wallis (EMSSA)
  • Past-president Dr. Peter Cameron (ACEM)
  • Vice-president Dr. Jim DuCharme (CAEP)
  • Treasurer Dr. Andrew Singer (ACEM)
  • Secretary Dr. Robert Schafermeyer (ACEP)
  • Member at Large Dr. Melanie Stander (EMSSA)

Current Regional Representatives on the IFEM BOD
  • Africa Prof. Lee Wallis (EMSSA)
  • Asia Dr. Kang Hyun Lee (Korea SEM)
  • Australasia Dr. Anthony Cross (ACEM)
  • Central and South America Dr. Edgardo Menendez
  • Europe Dr. Juliusz Jakubaszko (PSEM)
  • North America Dr. Terry Mulligan (ACEP, ACOEP)

Map of Current IFEM Members
(pink are founding and full members, and
gray-green are affiliate members)
Countries Currently Represented as IFEM Founding
or Full Members
  • U.S.A., Colombia, Panama, Australia, Bahrain,
    Canada, China, U.K., Turkey, South Africa, Hong
    Kong, Hungary, Ireland, Israel, Korea, Malaysia,
    Netherlands, Poland, Argentina, Dominican
    Republic, Mexico, Peru, Venezuela, India,
    Singapore, South Pacific, Sweden, Taiwan,
    Thailand, Trinidad / Tobago, Tunisia, Uzbekistan,
    Costa Rica, Philippines, Iran, Chile, Iraq, Cuba,
    Emirates, Georgia, and Vietnam

Countries Currently Represented by Affiliate
Members of IFEM
  • Turkey, Panama, Madagascar, Brazil, Denmark,
    Germany, Lebanon, Pakistan, Spain, Sri Lanka,

Current IFEM Ex-officio Members
  • African Federation for EM
  • Asian Society for EM
  • ALACED (Latin America)
  • European Society of EM (EuSEM)
  • Pan American Collaborative EM Development Program

Countries with Current or Recent Applications to
  • Iceland
  • Ethiopia
  • Tanzania
  • Oman
  • Ecuador
  • Mexican Association of Pediatric Emergency

IFEM Endorsed International Conferences
  • Symposium on Resuscitation in Mexico, June 2011
  • Symposium on Quality and Safety in Emergency Care
    in the U.K., November 2011
  • 8th and 9th New York City International
    Conferences on EM, New York City, August 2011 and
    August 2012

Upcoming ICEMs(ICEMs will be held every year
starting in 2019)
  • Cape Town, South Africa April 18 to 21, 2016
  • 2018 Mexico City, Mexico
  • 2019 and 2020 bids are being considered
  • 2021 bids are open

Summary of IFEMs Activities Related to
Developing E.M. Training Globally
  • Published standardized curricula
  • Medical student, residency, and Continuing
    Professional Development (post-residency)
  • Conducting the I.C.E.M.
  • Web site open access posting of lectures and
  • Consensus manuscripts from the various IFEM
  • Collaborating with SAEM / GEMA and the ACEP
    International Section in their international
    training efforts

Educational Value of the 2014 I.C.E.M. in Hong
  • 10 preconference workshops
  • 6 plenary lectures
  • 10 simultaneous tracks with 100 topic sessions,
    323 presentations
  • 260 speakers
  • 144 oral abstracts, 555 posters
  • 4 tracks presented in Chinese
  • 2287 attendees from 66 countries

Proposed New Undertakings for IFEM Related to
E.M. Training
  • Core Curriculum and CPD Committees to develop
    IFEM endorsed educational podcasts, satellite
    symposia, preconference workshops, and focused
    single topic conferences
  • Support development of regional trans-national
    E.M. board certification
  • Latin America, Europe, Asia, Africa

Current Challenges for IFEM
  • Obtaining more funding and expanding its office
    and support capabilities
  • Perhaps some competition with other international
    organizations such as WADEM
  • Improving relations and collaborations with the
    regional EM organizations such as EuSEM
  • Getting more countries to develop national EM
    societies and then join IFEM

Potential Broad Future Activities and Goals for
  • With World Health Organization collaboration,
    establishing and maintaining high quality EM in
    all countries
  • Standardizing transnational clinical care and EM
    training protocols
  • Using EM to contribute to peace and stability

How Can You Interact with IFEM ?
  • Volunteer for, and get appointed to, an IFEM
    committee, task force, or special interest group
  • Attend the ICEM
  • Attend the multiple IFEM meetings held at ACEP
    Scientific Assembly each fall
  • Help a country you are working in to develop a
    national society of EM and then have that
    organization join IFEM

IFEM Contact Information
Carol Reardon, Executive Director International
Federation for Emergency Medicine 34 Jeffcott
Street West Melbourne, VIC 3003, Australia Phone
61-407-042-543, fax 61-(03)- 9320-0400 Emails ,
. Website http//
IFEMs Role in Developing E.M. Training Programs
Globally Lecture Summary
  • IFEM has already produced widely accepted
    standardized curricula for E.M. training
  • The ICEM has been an excellent educational venue
    for emergency physicians
  • There is huge opportunity for further
    collaboration of E.M. physicians and
    organizations with IFEM in developing and
    conducting EM. training