Texas Recognizes ABPS Certification


The Texas Medical Board ruled on Oct. 20 that physicians certified by the American Board of Physician Specialties (ABPS) could advertise themselves as board certified to the public.

The ABPS is the certifying body of the American Association of Physician Specialties (AAPS). The ABPS sponsors 17 boards of certification, including the Board of Certification in Emergency Medicine (BCEM).

For a number of years, ABPS, in conjunction with AAPS, has been seeking recognition from various state medical boards, requesting that they allow physicians certified through an ABPS board to advertise themselves as board certified. The organizations were successful in Florida in 2002 but were recently rebuffed by the State of New York due to the lack of residency training as a qualification for ABPS board certification.

ACEP does not recognize BCEM as a certifying body in emergency medicine.

The Texas Medical Board ruling came as a surprise to the emergency medicine community, said Dr. Angela Gardner, ACEP president.

“We are very concerned that this ruling was done without the input of any of the organizations representing emergency medicine,” said Dr. Gardner. “Neither ACEP, AAEM, the Texas chapter, nor to our knowledge, any other medical specialty organizations were asked to submit written comments or testify at public hearings.”

After the ruling was announced, ACEP sent a letter to the Texas Medical Board asking for a clarification and requesting through the Texas Open Records Act, all documents, letters and communications relating to the ruling.

Once ACEP hears from the Texas Medical Board, a decision will be made on the next course of action. “We may ask for a public hearing, or the Texas Chapter may ask that this ruling be reconsidered,” said Dr. Gardner. “Important decisions that impact the physicians and patients in a particular state should be made with the input of those physicians and their specialties.”

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  1. #1 by Dr J - November 18th, 2009 at 08:09

    Disturbing that this could happen in Dr Gardner’s home state, but shame on Texas for devaluing our training.

  2. #2 by AFMD - November 18th, 2009 at 12:30

    By recognizing the ABPS/BCEM in Dr. Gardner’s and ACEP’s own backyard, the Texas Medical Board is making a very strong and powerful statement that this bickering and bullying around by ABEM/AAEM has to stop once and for all and that the two have alot to offer in providing patient care. There is no shame in this, just maturity on the part of the Texas Medical Board.

  3. #3 by Samuel S. Bear - November 20th, 2009 at 16:45

    Interesting…interesting…interesting….I think it very arrogant for ACEP to say they don’t “recognize” BCEM as a certifying body —- who are they? A state medical board? A governmental entity? No — ACEP is yet another special interest group trying to protect its own turf. I know that one of ACEP complaints against BCEM docs is that some of them don’t have residencies in Emergency Medicine. Did you know that fully 38% of ACEP’s own national board of directors don’t have residencies in EM? Talk about hypocrites!

  4. #4 by Ivan Antonio - November 22nd, 2009 at 13:03

    Very interesting… the number is more like 43% of ACEP’s own national Board of Directors don’t have residencies in Emergency Medicine. Six out of the fourteen national Board members did not do an EM residency but who is counting. And the National Council Speaker did not do a residency in anything. So ladies and gentlemen lets not be hypocrites.

  5. #5 by Greg Owens - November 24th, 2009 at 12:16

    Wow! 43% of the National ACEP Board members did not do an EM residency. And Madame before you ask The Texas Chapter to approach the TMB about the BCEM decision, remember that the current Texas Chapter president is not ABEM or AOBEM boarded and did not do an EM residency. You need to be reminded that you represent ALL ACEP members.What hypocrisy.

  6. #6 by Bryan Benedict - November 25th, 2009 at 12:24

    If ACEP was really concerned about patient care they would devise an additional training track for non EM residency trained physicians to gain additional training in EM. It is well documented that there are not enough EM residency physicians to fill all the ED jobs in the country. This clearly shows that this is a turf control and money issue for ACEP and not a patient care issue. ACEP continues to try to block ABPS from trying to provide certification for qualified ED physicians.

  7. #7 by veera sudireddy - November 25th, 2009 at 12:28

    Quiet interesting.How can ABEM be hypocratic.
    They have to recall that a few years ago there was no ABEM.What is their problem if someone
    else is trying to get their competant board recognised

  8. #8 by Mark Luce MD - November 25th, 2009 at 12:53

    We live in trying and dificult times. Greed and hipocricy got us here. True concern for others and teamwork will be needed to get us out. Working to adress the needs of patients and communities and physicians and health care systems is supposedly occurring on all levels as we speak. The findings of the state board of Texas (venerable home of many, including such level headed and pragmatic minds as Ron Paul) should be welcome news to those who value the principles that made our country great.Competition is know to many as a good thing for the end product delivered.

  9. #9 by Steve Kuplesky MD - November 25th, 2009 at 12:54

    The ABEM resistance to BCEM docs has nothing to do with quality of care, but everything to do with an arrogant attitude of “we’re best because we were first”. Show me evidence that indicates BCEM physicians fail to perform up to the high standards of Emergency Medicine. Until then, I suggest you back off and find something better to do with your time.

  10. #10 by David McMillan MD - November 25th, 2009 at 13:02

    A great breakthrough for AAPS and the BCEM. If it can be done in Texas, hopefully the resistance will start to break in other states, and ACEP can learn to live with AAPS. We are not the enemy.

  11. #11 by K. Sennholz M.D. - November 25th, 2009 at 13:30

    Way to go, Texas. Patients win in this one. Enough is enough. This bullying will go away by itself as the physician shortage causes more rational thinking. I’m old enough to have seen all paradigms and the old question: Is ER really a separate specialty? comes up again. A fellowship on top of primary care really make the most sense. With logic having failed us, at least the Texas Board has come to its senses.
    To you ABEM folks: how many of you are backing in to primary care after an ED career? Would you like to be treated with respect in your passage? Perhaps treating your brothers in medicine the same would go a long way. Meanness never wins.

  12. #12 by Leslie Mukau - November 25th, 2009 at 14:04

    Texas should be applauded for doing the right and sensible thing. It is about time and I hope this becomes a trend. I am one of those BCEM boarded ER docs that just missed grandfathering by 1 year. I work in a small town but busy ER where very few are ACEP “grandfathered” boarded. We have had many RT docs join us throughout the years but none stayed. Some were fired for plain incompetence.(Interestingly all the fired docs were RT trained!) The area is poor and semi remote and the work is very rigorous with practically no support services. We do all our own intubations, chest tubes, central lines, orthopedic reductions as well as all the critical care emergencies in the entire hospital.This ER is not for the freshly minted ED grads!
    So please quit spreading the fallacy that only RT ER docs can do a superb job in the ER. In the last 17 years working in this ER I have come across RT docs who should not be working in any ER let alone touch a patient.The future trend is for only RT trained docs to work in the ER. Yes, that is a good thing. The present reality is that there are not enough RT trained docs to staff all the needed positions. My training background was one year internship in medicine and three years in general surgery. This training included running the OB/Gyn, Orthopedic/Burn clinics and the Surgical Critical care Unit. Oh, by the way, I was also a 2 year Surgical Nutrition Fellow at Johns Hopkins University Hospital where part of my job description was to put in central lines for TPN (over 2000–yes that is thousand and not a typo, with one small PTX). I ended up in the ER because of personal circumstances. I challenge anyone to show me any ER residency training program that can match my background training. I also challenge any of you trash talking ABPS and BCEM to take their exam. Get off from your high horses and let us all work together and support one another as ER docs in improving access and care to all ED’s across the nation. We must also remember that continuing education is much more important than the knowledge garnered at some training program eons ago.

  13. #13 by Craig Pickren M.D. - November 25th, 2009 at 16:59

    Unbelievably arrogant of ABEM to take this position under the guise of “quality of patient care”. Everone knows there’s not a rip of difference between the ABEM and BCEM. They both use the same book. This is about money- plain and simple.

  14. #14 by Peter Lawrence MD - November 25th, 2009 at 20:28

    Centralline, your statement that AAPS/BCEM was “recently rebuffed by the State of New York due to the lack of residency training as a qualification for ABPS board certification” belies a peripheral understanding of the decision.

    Challenges to State statutes are analysed under a legal theory called “rational basis”, where the plaintiff usually never wins, and the State’s rules/regs are almost always upheld.

    Thus, AAPS/BCEM argued as follows; New York State maintains that any ER physician listed on its website as board certified completed a residency in emergency medicine. Since that is not true as numerous ER physicians in NY were grandfathered without an ER residency, AAPS sought a declaratory judgment to remedy this inherent fraud.

    AAPS/BCEM argued that if it was New York’s intention to list only those ERMDs that completed a residency in ER medicine as board certified in EM, then they should not list the ABEM grandfathered docs since they did not do an ER residency.

    AAPS/BCEM asked that since many of it’s docs are, at a minimum, similar to the grandfathered ABEM docs, that either those docs be de-listed and identified separately OR at the very minimum, that AAPS/BCEM certified docs be listed in a separate group.

    In other words, the grandfathered ER docs and the AAPS/BCEM docs, both having NOT done ER residency training, should not be listed as having done an ER residency. It basically perpetrates a fraud.

    Under rational basis, the judge held for New York because it was legally “rational” for them to maintain the site as they see fit.

    This in fact perpetrates a fraud, which you centrally contribute to by misstating the facts.

  15. #15 by S John Pappas, MD - November 26th, 2009 at 09:03

    As a physician, non-ER trained, and boarded through AAPS, it seems amazing that ACEP, who was founded by NON-ER physicians, now snubs their noses at the alternative board emergency room physicians. After practicing emergency medicine in a Level I trauma center for over 18 years, I have never been questioned as to my training or abilities. In fact, people are surprised when I tell them I trained in Internal Medicine. Experience and the desire to quiet the naysayers, is a wonderful tool. I dare say ACEP’s concern is monetary. Ya think?????

  16. #16 by Carlos Alvarado - November 26th, 2009 at 15:08

    ACEP’s hypocrisy and self-serving efforts are clearly evident in their effort to prevent AAPS to succeed in serving the medical needs of the American public. Plenty of evidence show residency trained ER physicians will not ever be able to satisfy the growing needs of staffing Emergency Rooms throughout the US……..ACEP: serve the patient, not your pockets!!!!!!!!!!!!!!!

  17. #17 by Lewis Marshall, MD, JD - November 27th, 2009 at 11:45

    All of these comments are apropos. ACEP is a membership organization, period. It should promote the protection of patients in the ED. Years ago there was a meeting between ACEP and AAPS to discuss ACEP’s position on board certification. Criteria were developed to be used to recognize boards in EM. Open minded leaders within ACEP moved to bring EM together. Now, as we move toward performance measures as the way to determine the competence of practicioners, the exam is fast becoming irrelevant. ACEP should do what it does well, EM education, promote patient safety in the ED and provide services to the practicing EM physician.

  18. #18 by D S Huck MD - November 27th, 2009 at 20:08

    It’s about time someone somewhere (i.e. Texas) came to their senses. As an IM trained, BCEM certified, ED physician with 20 years experience, I have completed the equivalent of ED residency training many times over. I missed ABEMs grandfather by ~ 2 years, but does that make me less competent? How many thousand intubations, central lines, and chest tubes does it take? While I would never suggest that in this day and age this is how one should enter emergency medicine, It’s time to recognize that real world experience does indeed render a degree of credibility and skill that should be acknowledged. To those who continue to insist one can not be an emergency medicine physician without a residency, I say grow up and get over it! You no longer need to demand to be taken seriously because you are and ED physician. Everyone now recognizes that EM is indeed a real and respected specialty.

  19. #19 by Greg Owens - November 30th, 2009 at 06:10

    The new President elect of ACEP; Sandra Schneider is “Board Certified” but did her residency in Internal Medicine. Why can she say that she is Board Certified. Did anyone say anything about quality care? Many of the “residency trained” and “Board Certified” EM docs are not necessarily quality docs. Many of us have been practicing EM for MANY years and provide QUALITY care. We should be able to advertise as board certified, just as so many others like ACEPs new president elect who are NOT residency trained!

  20. #20 by Doc W - December 1st, 2009 at 17:18

    ACEP members who are not EM residency trained should ask themselves whether the ACEP leadership is protecting the interests of its EM residency trained members above their own, and if so, why are they contributing their hard-earned dues to an organization that publicly considers them as “second rate”?

    This is not the first time that the ACEP leadership has campaigned against ABPS which allows non-EM residency trained physicians to take its EM certification exams. Florida ACEP chapter president Mylissa Graber wrote in an EM Pulse editorial:

    “if a physician who is a family practice doctor chooses to work in these areas in the ED, that is fine, but s/he is still a family practice doctor,not an emergency physician and there is no shame in that.
    Just don’t misrepresent who you are.
    In the same way,when I do a pelvic exam, I do not tell the patient I am a gynecologist, and when I put in a chest tube, I do not say I am a cardiothoracic surgeon…
    This fight is not over and we will continue to pursue residency training in EM as the only appropriate pathway into emergency medicine today, but it is time for the emergency medicine residency-trained docs to stop sitting on the sidelines and join this fight. ”

    The only reason that NY DOH does not recognize ABPS certification is because EM specialty organizations such as ACEP and AAEM actively campaign against it. (For history on the NY and Florida ABPS battles, go to:
    http://www.docwhisperer.wordpress.com)

    The question begs to be asked, is ACEP only representing the EM residency trained/ ABEM certified docs? Seems like it, from Dr. Gardner’s comments.

  21. #21 by Mark Desantis DO - December 3rd, 2009 at 09:52

    It is quite sad to see such posturing on behalf of Dr. Gardner, before she evaluated the requirements to be certified by the ABPS. They actually are more stringent in many requirements then other current boards. I will also say that the Osteoptahic Board also in the past accepted physicians accepted to the ER Board exam without residency. The ABPS is the third largest multi-specialty physician/surgeon certifying entity, providing board certification to both allopathic (M.D.) and osteopathic (D.O.) physicians. I would ask Dr Gardner to review this material. http://www.abpsus.org/downloads/comparative%20matrix.pdf.
    In my opinion Texas did the correct action and should be applauded.

  22. #22 by Sam S. Pearson, M. D. - December 7th, 2009 at 11:26

    As Davy Crockett may have said at the Alamo…ACEP is the propagandist of the big contract management groups…Money doesn’t talk…it screams!
    Congratulations to the Texas Medical Board on sticking to their guns and seeing through this ruse and support AAPS/BCEM members along with their right-to-work

  23. #23 by Michael Parker, MD - December 7th, 2009 at 23:05

    The problem lies in a difference of opinion regarding whether one should complete a residency to obtain board certification. ABEM currently requires it, and AAPS does not.
    AAPS physicians usually have board certification in another speciality, which is a requirement for BCEM certification, but ABEM states this is not the same as an ER residency. Nor is the 5 year practice requirement, although some would claim otherwise.

    ABEM and ACEP refuse to accept the AAPS certification, because that would negate their position that a residency should be completed to obtain board certification.

    A possible solution, would be a 1 year ER fellowship at the senior level. Entry would be contingent upon having obtained Board Certification in an approved primary care speciality, and 5 years of practice certification. Upon successful completion of this year at the senior level, and documentation of procedures done, the candidate should then be to sit for the appropriate exams for certification.

    Currently, there are several paths to obtain board certification in Critical Care. One can complete a surgical residency, a pulmonary fellowship, or an anesthesia residency and complete a year of fellowship in Critical Care and be eligible to sit for Critical Care Boards.

    Hence, there are several ways to become Board Certified in Critical Care, and all of these paths then lead to running an ICU, and there really isn’t controversy about who is better. Perhaps a similar route can be established for Emergency Medicine with AAPS taking the initiative in presenting this to ABEM, after establishing this as a requirement for their future candidates.

    All of us would agree that family medicine residency is a good background for ER medicine, but is still not a substitute for ED residency. A family doc would have to brush up on reading x-rays, ct scans, and become skilled at intubation, chest tube placement, central line placement, trauma management. This could occur with supervision at the senior ED fellowship.

    Working toward this would make more sense than filing lawsuits back and forth at the state level, with neither side really winning much of anything.

  24. #24 by K. Quinn - December 9th, 2009 at 04:22

    The gold standard for working in an emergency department is completion of a emergency medicine residency program. Plain and simple, to call yourself board certified, you need to have completed an emergency medicine residency program.

  25. #25 by T. James - December 9th, 2009 at 11:22

    There is NOT only one way and NO one gold standard to be board certified in EM. To think that the only way to become board certified through EM residency is just simple minded.

  26. #26 by D. Anderson - December 10th, 2009 at 10:00

    Agree with T. James….that simple minded thinking is what got this branch of medicine in trouble and is looked upon as a joke in the first place.

  27. #27 by K. Quinn - December 11th, 2009 at 06:57

    You can call it simple minded or whatever you want it doesn’t change that it’s a fact. There is a reason emergency medicine residency programs exist. To be a board certified surgeon you have to complete a surgery residency and the same goes as for other specialties. I can’t complete an emergency medicine residency and then call myself a board certified family physician. I have no problem, if family practice physicians or other physicians want to work in the emergency department. No one is stopping them. But they shouldn’t be able to call themselves board certified emergency medicine physicians. I know it upsets people but seriously how is that fair to the many emergency medicine residents who actually complete an EM residency program and graduate to share the same title with individuals who haven’t done the same training. Its simple minded to believe that some people can avoid the work but reap the rewards.

  28. #28 by D Huck MD - December 11th, 2009 at 17:38

    Dear Dr. Parker. I’ve been doing this for 20 years. I ain’t going back for no fellowship so you can take my job

  29. #29 by Doc W - December 11th, 2009 at 19:35

    Dr. Gardner’s comments make it clear where ACEP stands. I applaud the support shown by many of the commenters above for ABPS’ efforts to advocate for non-EM residency trained physicians in Florida, Texas, Oklahoma and other states. While much appreciated, ABPS needs more than comments on a blog to continue. I encourage anyone who’s truly interested to contact ABPS (www.abpsus.org) and offer their help in this matter.

  30. #30 by Michael Parker, MD - December 13th, 2009 at 04:32

    Dear Dr Huck. I too have been doing this for 20 years, and am not interested in taking your job. No need to state, but there always will be a job available in ED medicine, when you return from a fellowship. It’s probably the one year cut in pay, you are more worried about

    After 20 years of ER medicine, I completed an anesthesia residency, and now am ABA boarded, and plan on doing a critical care fellowship to be Board Certified in Critical Care. But for now, I’m working full time as a ED doc for the moment.

    I advocate any endeavor that furthers learning, so I for one would probably be happy to do a fellow-ship for a year.

    However, I’m not advocating that for all ABPS-BCEM members, just that we should consider this as a requirement for future members, so that a meeting of the minds can be made between ACEP and ABPS.

    Perhaps a proposal can be made to ACGME
    Accreditation Council for Graduate Medical Education

    http://www.acgme.org/acWebsite/newsRoom/newsRm_acGlance.asp

    I, for one, think that avenue is the one that would eventually legitimize ABPS-BCEM to the same level as ACEP-ABEM.

  31. #31 by Doc W - December 15th, 2009 at 10:14

    Dr. Parker, your proposal seems to be entirely rational and would be the best solution for the communities served, but until ACEP/AAEM stop clinging to the idea that only EM residency trained docs can provide quality care in the ER, then unfortunately this issue will continue.
    I would also encourage any non-EM residency trained physicians in Texas to write to the Texas Board of Medicine supporting ABPS recognition.

  32. #32 by Texas Doc - December 15th, 2009 at 14:29

    As long as physicians spend their time and effort fighting among themselves, Obama and his friends can railroad the whole lot and leave you wondering what happened.

    My Boards are bigger than your boards.

  33. #33 by AEP - December 15th, 2009 at 15:01

    If only there was an ER Physician organization that embraced All Er Physicians and was not a board or a test but an Association of Emergency Physicians

    We could all work together instead of divinding and pointing fingers.

  34. #34 by DocW - December 16th, 2009 at 10:18

    Why has the comments section on the post on the ACEP statement on ABPS recognition in Texas been shut down? Is this censorship via “technical difficulties”

  35. #35 by Ron Cunningham - December 16th, 2009 at 10:37

    The comment section is up and accepting comments. The ACEP Web site was down for about 30 minutes last night for a software upgrade.

  36. #36 by Samuel S. Bear - December 17th, 2009 at 21:31

    What’s the old saying? “Those in glass houses shouldn’t throw stones?”

    Here we have ACEP complaining that BCEM docs don’t have their residencies in EM when in the incoming president, Sandra Schneider, DOESN’T have her residency in EM.

    Oh, but it gets better —

    Fully 40% of ACEP’s national board of directors don’t have their residencies in EM.

    Oh, but it gets even better —-

    Board members of ABEM, Robert E. Collier, MD
    Director, American Board of Emergency Medicine and Joel M. Geiderman, MD
    Director, American Board of Emergency Medicine DON’T have residencies in EM either.

    And yes….there is more…

    Our friends @ the American Academy of Emergency Medicine (AAEM), yet another critic of ABPS’, has leaders w/o EM residencies:

    * William T. Durkin, Jr., M.D., 2009 – 2010 Secretary/Treasurer, American Academy of Emergency Medicine.
    * Steven C. Gabaeff, MD, Past President, California Chapter of the American Academy of Emergency Medicine.
    * John B. Christensen, MD, Past Board Member, 2002-2003 CAL/AAEM Board of Directors.
    * Vincent J. Markovchick, MD, 2001 AAEM
    “Peter Rosen Award” Winner.
    * Robert W. Derlet, MD, Past Board Member, 2002-2003 CAL/AAEM Board of Directors.

    How do you spell hypocrite? A-C-E-P

  37. #37 by A Board Certified Emergency Doc - January 4th, 2010 at 03:58

    It seems to me every argument made by those advocating re-opening the grandfather track could be made by those who want to practice medicine without going to medical school. Why should someone have to go to medical school to call themselves an MD? It’s completely unfair. Training in a related field and spending some time practicing on their own in some small town that can’t get any MDs to move there is the same thing isn’t it? No, of course not. And it is just as ridiculous to call a non-residency trained emergency physician a board-certified emergency physician. Likewise you could argue it would be better for patients to have access to more health care providers, whether they actually bothered going to medical school or not. But that argument is just as easy to see through as yours.

    How long would you have us keep the grandfather track in place? Forever? That’s what accepting BCEM as equivalent to ABEM would do. No medical specialty does this.

    No one is arguing against your ability to work in any ED that will hire you. If a particular ED (like mine) won’t hire you to work the main side or won’t pay you as much as someone who did an EM residency, how is that the fault of ACEP/ABEM/AAEM etc? You made your choice, either in medical school when you chose to do a non-EM residency, or if you’ve been out a long time, not to do the grandfather track during those first few years before it closed. Now you have to live with the consequences. We’ve all got consequences-I can’t go put up a shingle and call myself a board-certified family doc for example. Could I open a practice as a GP? You bet, but you know as well as I do there is a big difference between a doc who did a one year internship and one who did a 3 year FP residency. If you really want a job that requires EM board-certification, go back to residency. It’ll cost you a few years of higher pay, but if you think it is worth the investment, no one is stopping you.

    And no one in their right mind would argue that every residency trained, ABEM-board-certified doctor is a better doctor than every non-EM-residency-trained emergency physician. That’s a stupid argument.

  38. #38 by TJMD - January 5th, 2010 at 09:57

    “A board Certified Emergency Doc”

    You really don’t have a clue what’s going on out there….

    Not only is ABEM trying block job opportunities for non-residency trained docs, but no one has even begun to mention the fact that they are ALSO BLOCKING ATTEMPTS TO RETURN TO RESIDENCY! The moment programs hear that someone is boarded in a Primary Care Speciality with thousands of ED experience, the application is immediately thrown out, and the favorite excuse is, “we can’t accept you because you already completed a residency and we can’t fund you”….

    Besides, there is way too much redunancy between Primary Care residencies and EM residency training that doing 3 years is simply unnecessary. Previous comments made include a 2 year fellowship. Two years is really pushing it. Look at the curriculum closely. Nine months to possibly 18 months would certainly due.

    Because of so much overlap in training, you’re right about the arguement of residency trained ER docs being better than non-residency trained ER docs of being stupid. But who’s saying that, the majority of residency trained ER docs…go figure.

  39. #39 by Scott - January 7th, 2010 at 13:34

    It’s true that a significant number of ABEM certified physicians did not complete EM residency training. It is also true that many fine physicians practice EM under the BCEM label, or with no EM label at all. There are no studies that demonstrate than a residency trained EM physician practices better medicine than a non-residency trained EM physician. Therefore the ACEP position is an irrational one. If all emergency physicians could cooperate and come to some compromise on this distracting issue, as opposed to continually acting like children protecting their favorite blanket, then the emergency medicine community as a whole would benefit greatly. Stop bickering and learn to play nice with all the other children.

  40. #40 by Chris - January 17th, 2010 at 16:06

    Actually, I work in an ER and as a hospitalist. I did a family practice residency. I think a 1 yr fellowship after FP or IM is all you’d really need to do ER. the best Er docs I’ve ever known were FPs or Internists; the comprehensive training goes a long way. Absolutely politically incorrect to say, but, I think alot of people believe it to be true. I didn’t do ER residency because it was limited in academic scope, limited in opportunities and quite frankly, no one though much of their training.
    sorry, just my two cents.

  41. #41 by Curt - April 24th, 2010 at 18:17

    Sorry folks. ER, relatively speaking, is one of the newer specialities. Of course there are a number of those currently in the ACEP who were grandfathered in. And a lot of these folks have set the ground work for what constitutes a good ER physician and the appropriate practice of Emergency medicine. I realize that to a lot of you who are IM, Surg, FP believe that there is little required to do a good Job in the ER… But the point is, our approach is quite the opposite to your approach in your respective fields. I certainly dont believe that as an ER physician, I have any business going into Family practice, Surgery, etc without going through your residency programs. Not to say that some credit should be given to those who are seeking a different specialty if they have completed their own residency. Chris, with regards to limits in clinical scope, i find it interesting that any time a patient comes to an FPs office that they are not comfortable with, well they end up in the ER. And its not speaking badly of FPs, it is simply that our scopes of practice and clinical / procedural skills are a totally different set. Likewise, with the general surgeon who can certainly manage a trauma, place lines, order appropriate abx, well how would he or she know how to manage a pregnant vag bleed or a 6 week old febrile patient? Not to say that he or she couldnt be trained to do so, but the training would be necessary to maintain consistency in the practice of emergency medicine.

    If you are interested in the practice of emergency medicine, by all means, apply to one of our residencies. We would prefer to have those with additional skill sets to join our ranks.

    But think of it this way, you wouldn’t be too happy if I moved into your town and placed a shingle as a dermatologist, or a FP. Likewise, I didn’t complete a 4 year residency program to be told that any of you are equally qualified to practice in my field.

  42. #42 by Dr. JB - April 30th, 2010 at 14:30

    So what you are saying is that because I haven’t done a residency in EM but have worked in an ED for almost 20 years that a residency trained doc with less than 10 years er experience is better than I am?

  43. #43 by WCR - June 2nd, 2012 at 14:09

    #41, A lot of ER docs do hang a shingle and practice primary care when they retire from ER medicine. Will you still be doing overnights in a busy ER when you are 60 years old?

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