Just the Facts:Coaching in emergency medicine.

Emergency medicine: past, present, and future challenges

Forget Paris: Emergency Physicians Can Soon Sit for US Critical Care Boards

Emergency Care Crisis in the United Kingdom and Ireland: Emergency Physician Exodus Looms in Wake of Pay Cuts, Staffing Shortages

PurposeTo evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.MethodsA 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”ResultsIn total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.ConclusionInternal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.

ACEP Ambassadors Globalize Emergency Care

Unscrambled: Every Emergency Medicine Spot Filled in Residency Match

Acute chest discomfort is a common clinical problem that has to be well understood and managed collaboratively by specialists from many fields of medicine. This study aimed to explore and evaluate the perspectives of healthcare professionals in family, emergency, and internal medicine regarding the management of acute chest pain, with a specific focus on diagnostic practices, interdisciplinary collaboration, and protocol adherence to establish best practices for a unified approach. This cross-sectional study, conducted from June 2022 to July 2024, included 218 healthcare professionals with over a year of experience in family, emergency, and internal medicine, selected through convenient sampling from hospitals such as Lady Reading Hospital, Hayatabad Medical Complex, Mardan Medical Complex, and Government Mian Meer Hospital. Data was collected through structured questionnaires covering demographics, clinical protocols, inter-disciplinary communication, and management challenges, complemented by semi-structured interviews for deeper insights. Statistical analysis was performed using SPSS version 26, with chi-square tests comparing responses across specialties, considering p < 0.05 as statistically significant. Results: The results showed that emergency medicine practitioners had the highest use of diagnostic tools, with 80 out of 80 (100%) using electrocardiogram (ECG) and 78 out of 80 (97.5%) using troponin tests, compared to 60 out of 70 (85.71%) and 40 out of 70 (57.14%) in family medicine (p < 0.001 for both). Additionally, 70 out of 80 (87.5%) in emergency medicine reported time constraints affecting management. Communication barriers were noted by 50 out of 80 (62.5%) in emergency medicine and 45 out of 70 (64.29%) in family medicine. Interdisciplinary collaboration was reported at 50 out of 70 (71.43%) in family medicine and 60 out of 80 (75%) in emergency medicine. A lack of standardized protocols was especially high in internal medicine, impacting 65 out of 68 (95.59%) participants (p<0.001). Emergency medicine professionals consistently utilize diagnostic tools like ECGs and troponin tests more frequently, reflecting their time-sensitive clinical environment, but also report significant time constraints. In contrast, internal medicine practitioners, who generally have more years of experience, reported the highest adherence to management protocols, yet they also identified a lack of standardized guidelines as a major barrier. Family medicine professionals, while showing strong interdisciplinary collaboration, had lower utilization rates of advanced diagnostic tools, which may impact early decision-making. These disparities underline the need for unified protocols and improved communication pathways across specialties to enhance diagnostic accuracy and streamline management.

Globally, emergency medicine is continuously evolving and in numerous countries, societies and colleges help develop the specialty on a professional and academic level. However, there are countries, including Switzerland, where emergency medicine is not a fully recognised specialty and there is a historical gender gap. It was the aim of this study to investigate the trends and developments in Swiss emergency medicine in terms of physician workforce, gender equality and academic posts over time. In this observational longitudinal analysis, the number and gender distribution of Swiss Society of Emergency and Rescue Medicine (SSERM) members as well as SSERM-certified physicians were analysed in 2011, 2016 and 2021. Additionally, head and leading physicians of SSERM-certified emergency departments of category 1 and 2 were analysed in 2021 with special regard to gender distribution. Finally, an analysis of Swiss academic emergency medicine including Swiss academic tracks, professors in emergency medicine as well as committees, chairs and speakers of the annual SSERM conference was performed. From 2011 to 2021, there was an increase in SSERM members of 52% and a growing proportion of women from 26% to 35%. Similarly, there was a rise of 66% in physicians certified in in-hospital and 79% certified in prehospital emergency medicine. The proportion of women increased by 153% and 131%, respectively. In the analysed emergency departments, 69% of all head physicians were men whereas 50% of senior consultants and consultants with extended responsibility were women in 2021. Concerning academics, emergency medicine was a mandatory subject at all Swiss universities offering a master's degree in medical studies in 2021. However, 11 Swiss universities reported only six full professors, of whom only one was a woman, and three associate professors in emergency medicine in 2021. The analysis of the annual SSERM conferences from 2016 to 2019 revealed that men outnumbered women at every conference in terms of committees, chairs and speakers. The number of SSERM members and board-certified emergency physicians, women in particular, remarkably increased in 10 years. Equality appears to be within reach for clinical emergency physicians, but women continue to be underrepresented in academic positions, at scientific conferences and among professors. In Switzerland, academic emergency medicine appears to be lagging behind in view of the growing emergency physician and women workforce, which might complicate further progress in and development of Swiss emergency medicine on a scientific and professional level..

Historical Parallel Evolution of Injury Prevention and Control Science and Emergency Medicine

The Accreditation Council for Graduate Medical Education (ACGME) has outlined its "Next Accreditation System" (NAS) that will focus on resident and residency outcome measurements. Emergency medicine (EM) is one of seven specialties that will implement the NAS beginning July 2013. All other specialties will follow in July 2014. A key component of the NAS is the development of assessable milestones, which are explicit accomplishments or behaviors that occur during the process of residency education. Milestones describe competencies more specifically and identify specialty-specific knowledge, skills, attitudes, and behaviors (KSABs) that can be used as outcome measures within the general competencies. The ACGME and the American Board of Emergency Medicine (ABEM) convened an EM milestone working group to develop the EM milestones. This article describes the development, use within the NAS, and challenges of the EM milestones.

More Science for the New Subspecialty

Anaesthesiologists in emergency medicine: the desirable manpower

Each year approximately 1,000,000 people die by suicide, accounting for nearly 3% of all deaths and more than half (56%) of all violent deaths in the world (Krug, Dahlberg, Mercy, Zwi, & Lozano, 2002). Suicide ideation and suicide attempts are strongly linked to death by suicide and powerfully predict further suicidal behavior (Institute of Medicine, 2002). There are an estimated 100–200 suicide attempts for each completed suicide in young people, and 4 attempts for each completed suicide in the elderly (Institute of Medicine, 2002). Emergency departments (EDs) are the most important site, epidemiologically speaking, for treating those who make suicide attempts. EDs in the United States, for example, record over 500,000 suicide-related visits annually (Larkin, Smith, & Beautrais, 2008). The majority of suicide attempt patients are discharged after medical stabilization and psychosocial evaluation, but carry a significant risk of recidivism (Larkin, Smith, & Beautrais, 2008). Similarly, ED patients who present with suicide ideation (without attempt) have risks of returning to the ED with further ideation or with suicide attempts which are as high as those who present with attempts (Larkin, Beautrais, Gibb, & Laing, 2008). In addition, a significant fraction of those who present to EDs for nonmental health reasons often have occult or silent suicide ideation (estimated at 8–12%) (Claassen & Larkin, 2005). The worldwide economic tsunami and sky-rocketing healthcare costs have ensured that mental health-related visits and presentations for suicidal behavior will continue to rise in the foreseeable future. The closure of psychiatric inpatient facilities, reductions in inpatient beds, moves to treat people in the community, and increased costs of general practitioner visits have coincided with – and likely account for – increased ED attendances by psychiatric and suicidal patients who previously might have been admitted or seen in primary care. The ED is now the default, de facto option for urgent and acute contact for suicidal patients within the health system – and in many countries the ED is the only access to 24/7 healthcare (Fields et al., 2001).

NIH Launches Emergency Care Research Office: Coordinating Center Lauded but Challenges Noted

Subspecialisation in emergency medicine: A specialty at the crossroads.