Education

What is an Emergency Medicine Fellowship?

There are 2 main categories of Emergency Medicine fellowships.

One fellowship is for emergency physicians finishing a traditional emergency medicine residency. For these physicians, fellowship prepares highly qualified and motivated academic emergency physicians in a number of areas of emergency medicine, including leadership, research, ultrasound, medical oversight of pre- and out-of-hospital emergency care systems. These fellowship programs are recognized by the traditional board certifying entity, ABMS, the American Board of Medical Specialties.

The second fellowship is for physicians who have completed a residency other than emergency medicine and would like to become board certified in emergency medicine through an alternative pathway through ABPS (the American Board of Physician Specialties). While this track is not recognized by the traditional board certifying entity (ABMS, The American Board of Medical Specialties), these physicians do obtain experience specific to emergency medicine through this fellowship. To find a list of fellowships through this alternate pathway currently approved by the Board of Certification in Emergency Medicine, see here. Completion of one of these fellowship programs satisfies part of the eligibility requirements to become board certified in Emergency Medicine by the Board of Certification in Emergency Medicine (BCEM).

What are the important life support certifications in emergency medicine?

The American College of Emergency Physicians (ACEP) believes board certification by the American Board of Emergency Medicine (ABEM) demonstrates comprehensive training, knowledge and skill in the practice of emergency medicine. Although short course completion (examples below) may serve as evidence of focused review, the topics covered in such courses are part of the core curriculum of emergency medicine. Therefore, maintenance of ABEM certification does not require ABEM physicians to take these courses.

In addition, ACEP believes the Comprehensive Advanced Life Support (CALS) course is a valuable educational experience and is an equally acceptable alternative to other advanced life support and/or trauma life support courses. CALS may be of particular value to those who practice rural emergency medicine, as it is more comprehensive than other life support courses.

There are additional life support courses that can be completed including Advanced Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS), Pediatric Advanced Life Support (PALS), CALS and Basic Trauma Life Support (BTLS), or a specified number of CME hours in a sub-area of emergency medicine. The Basic Trauma Life Support is the most common of these certifications. BTLS, also known as Pre-Hospital Trauma Life Support (PHTLS), is designed to provide prehospital care providers with the skills necessary to provide a thorough assessment, initial resuscitation and rapid transportation of the trauma victim.

 

Emergency Medicine Residency

An emergency medicine residency is the training program an emergency medicine physician in-training enters following the completion of medical school.

Emergency medicine residency candidates must apply for individual programs through the Electronic Residency Application Service (ERAS). Qualifying candidates will interview with individual programs. After comparing and weighing the options, candidates submit a rank order list (ROL) through the National Resident Matching Program (NRMP). The ROL will be matched through a computer algorithm with the individual program’s rank list to determine where the candidate is placed.

Emergency medicine residency programs are typically three years or more. The first year, commonly referred to as PGY-1, is sometimes also referred to as an internship. Training extended beyond residency referred to as a fellowship.

Free Open Access Medical Education

Free Open Access Medical Education (FOAMed) is the concept of globally accessible educational medical content distributed across the web. It is an independent platform or media which often includes medical articles, blogs, podcasts, tweets, Google hangouts, online videos, text documents, photographs, Facebook groups and a number of other resources.

Graduate Medical Education (GME)

Graduate Medical Education refers to any type of formal medical education, usually hospital-sponsored or hospital-based training, pursued after receipt of the M.D. or D.O. degree. This includes internships, residency, subspecialty and fellowship programs which lead to state licensure and board certification.

To gain access to GME programs resident physicians, typically, have graduated from medical school and will spend three to seven years in graduate medical education (GME) training at teaching hospitals. Member teaching hospitals educate the next generation of physicians through excellent and essential clinical training.

Continuing Medical Education (CME)

Continuing Medical Education (CME) is a requirement for medical professionals to maintain certification, licenses, credentialing, professional society memberships and additional professional privileges. CME provides the opportunity for professionals to stay abreast in their specialty, develop new skills and gain knowledge of current topics and trends.

The specific requirements for CME vary from one specialty to another, but the credits are usually earned through a number of educational activities. Some fields have to complete specific credits annually, while other specialties have more flexibility in terms of the educational activities used to fulfill credits.

National Commission on Certification of Physician Associates (NCCPA)

The National Commission on Certification of Physician Associates (NCCPA) is the United States’ certifying organization for physician associates. It provides certification exams, specialty certification, recertification and certification maintenance. NCCPA certification is one of the criteria for licensure or regulations for physician associates.

Physician Assistant National Certifying Exam (PANCE)

The Physician Assistant National Certifying Exam (PANCE) is the certification exam offered by NCCPA. To be eligible for the PANCE, physician associate must graduate from the Accreditation Review Commission on Education for the Physician Associate (ARC-PA) or its predecessors.

Emergency Medicine Residency Program Requirements

For programs to become sponsored institutions accredited by ACGME they must follow certain guidelines to ensure residents are properly trained, supervised and evaluated based on field performance.

To earn accreditation, institutions must meet all educational components required of sponsored programs.

  • Curriculum Components
  • Consistent with the sponsoring institution’s mission, the needs of the community and the desired distinctive capabilities of its graduates
  • Competency-based goals and objectives for each educational experience designed to promote progress on a trajectory to autonomous practice
  • Delineation of resident responsibilities for patient care, progressive responsibility for patient management and graded supervision
  • Structured didactic activities
  • Advancement of resident knowledge of ethical principles foundational to medical professionalism
  • Advancement in resident knowledge of basic scientific inquiry principles, including how research is designed, conducted, evaluated, explained to patients and applied to patient care

The program must integrate the following ACGME Competencies into the curriculum

  • Professionalism
    • Residents must demonstrate a commitment to professionalism and an adherence to ethical principles
  • Patient Care and Procedural Skills
    • Residents must be able to provide patient care that is compassionate, appropriate and effective for the treatment of health problems and the promotion of health.
    • Residents must be able to perform all medical, diagnostic and surgical procedures considered essential for the area of practice.
  • Medical Knowledge
    • Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological and social behavioral sciences, as well as the application of this knowledge to patient care.
  • Practice-based Learning and Improvement
    • Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and lifelong learning
  • Interpersonal and Communication Skills
    • Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families and health professionals.
  • Systems-based Practice
    • Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, including the social determinants of health, as well as the ability to call effectively on other resources to provide optimal health care.

Throughout the program, the sponsored institution must evaluate, observe and critique resident performance during each rotation or education assignment.

Evaluations must be completed at the end of each process
For block rotations of greater than three months induration, evaluation must be documented at least every three months
Longitudinal experiences, such as continuity clinics in the context of other clinical responsibilities, must be evaluated at least every three months and at completion.

The program must provide an objective performance evaluation based on the competencies and the specialty-specific milestones using multiple evaluators (e.g., faculty members, peers, patients, self and other professional staff members); and provide the information to the clinical competency committee for its synthesis of progressive resident performance and improvement toward unsupervised practice.

How Many Years is Emergency Medicine Residency?

An Emergency Medicine Residency can take up to three to four years to complete. The length of the residency depends on the specific medical residency that is obtained. 

Most specialties offer fellowship training once residency is completed. A fellowship is typically one to three years based on the specialty. Fellowships have strong components of research as well as clinical and surgical experience. Fellowship training is the highest level of training a physician can obtain in a specified field.