Transforming the way emergency physicians learn and stay certified is one of the most critical and exciting missions of the American Board of Emergency Medicine (ABEM), according to Jill M. Baren, MD, MBA, the new ABEM President, who was elected in July and will serve for the 2019–2020 term.
Explore This IssueACEP Now: Vol 38 – No 10 – October 2019
Currently professor of emergency medicine, pediatrics, and medical ethics at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, as well as the provost‘s faculty leadership development fellow there, Dr. Baren has been a member of the ABEM Board of Directors since July 2012 and was elected to the Executive Committee in 2016.
Dr. Baren recently responded in writing to ACEP Now’s questions about her goals as ABEM President and the future of certification.
What are your goals during your year as ABEM President?
Thank you very much for this opportunity. It’s a pleasure to share my thoughts with the EM community in ACEP Now.
ABEM has two primary strategic objectives for this coming year. First, we have a record number of physicians to assess and need to make sure it’s done in a high-quality, fair, and valid way. Second is the development of MyEMCert (the alternative to the ConCert Exam) to keep pace with new advances that are integrated into our clinical practice. MyEMCert has the potential to transform the adoption of new information into our practices, something ABEM recognizes as high priority.
You are well-known as an academic emergency physician, but 75 percent of ABEM-certified physicians are community physicians. How do you assure community physicians that you understand their challenges?
Yes, 75 percent of ABEM-certified physicians are community physicians, and the ABEM Board includes several physicians who practice in a community setting. Additionally, almost 60 percent are involved in teaching medical students, residents, or fellows. That means the majority of ABEM-certified physicians are committed teachers, which is a perfect fit for our specialty. Emergency physicians are inherently the type of people who want to share what they know with other physicians and their patients. More important, the core of EM practice is similar across most community hospital and academic medical center settings.
Also, every emergency physician on the ABEM Board of Directors and all of our volunteer physicians, such as oral examiners, must be clinically active.
My clinical time is very important to me. As an ABEM Board member working shifts in the emergency department, I am subject to the same rules, regulations, pressures, and stresses that all frontline emergency physicians face.
What can you tell us about MyEMCert, the alternative to the ConCert Exam?
MyEMCert is our highest-priority development project—and it’s coming along nicely. MyEMCert will provide an option to the current program, which is the Lifelong Learning and Self-Assessment plus the 10-year ConCert Exam track. With MyEMCert, physicians will need to complete four modules every five years to keep their certification in good standing. MyEMCert modules will include about 50 questions and focus on specific topics, such as abdominopelvic presentations. Modules will also focus on new advances in the specialty. We are assembling a panel of EM experts—journal and textbook editors and evidence-based medicine specialists who will review new advances submitted by practicing emergency physicians. Many physicians said that they want continuing certification to help them become better doctors. We think MyEMCert is one way to do that.
What is emergency medicine’s most exciting opportunity? Conversely, what are the specific threats to our field that ABEM can address?
From ABEM’s vantage point, emergency medicine’s most exciting opportunity is to revolutionize knowledge translation in our specialty. Through MyEMCert, we can accomplish that goal. Our efforts are catalyzed and expanded when organizations such as ACEP provide a complementary emphasis in their educational programs. ABEM needs ACEP and other organizations as partners to continue to create a high-level educational environment in our specialty.
There are many threats to our specialty, but the ones I think are particularly concerning involve ED boarding and physician burnout. We must continue to attract the best and the brightest physicians into emergency medicine and ensure that we have the right landscape in our training and practice environments to support them. I also want to acknowledge that ACEP has been a leader in calling for protected time for residency core faculty and in taking on the issue of surprise billing.
Women and many minorities continue to be underrepresented in emergency medicine. What can ABEM do about that?
ABEM tracks residency demographic data closely and publishes an annual report in the Annals of Emergency Medicine. ABEM can set an example by encouraging and supporting women and underrepresented minorities to enter the profession. I am extremely proud that we have a very diverse Board and our newly elected Executive Committee is composed of 50 percent women, and about 75 percent of ABEM staff leadership are women. Most recently, all of the physicians selected to join our test-writing group are women. But we can always strive to do better. ABEM just formed a Diversity and Inclusion Expertise Task Force that will work to keep diversity and inclusion a priority for the Board.
ABEM also works hard to make sure that our physician assessment processes are not unfairly biased against certain groups. We perform detailed analyses to ensure that our test questions don’t contain ethnic or cultural biases. We’ve also analyzed our oral examination scores and found no difference in examiner scoring for men and women exam candidates.
Is there such a thing as too many emergency physicians? Too many residency programs? Does ABEM have a position on this?
Workforce is an important issue for our specialty, but ABEM does not offer policy opinions about it. ABEM is resolute that we will not adjust our examination passing standards to regulate the workforce.
I think ACEP is wise to be working with Edward Salsberg, the leading national expert on physician workforce issues, [on its Emergency Medicine Workforce Task Force project]. ABEM provided ACEP and other organizations data to help inform the specialty about workforce trajectories, especially as it involves certified physicians.
What can you share about yourself so that the EM community can get to know you even better?
I feel very fortunate to have combined clinical care, teaching, research, department chair administration, and service to the specialty throughout my 27-year career! I was one of the first emergency physicians to train and become subspecialty certified in pediatric emergency medicine. Although subspecialty certification provided me with a niche focus for my clinical and academic work, I continued to see the entire spectrum of emergency patients in my practice. It’s given me such an appreciation for the nuances involved in caring for different patients and learning how to be the best patient advocate possible. Getting involved and becoming a leader in various EM organizations allowed me to connect with colleagues across the country and listen to and consider their different viewpoints, which constantly reaffirms the importance of and my commitment to diversity and inclusion. I don’t regret the immense time commitment that it took to become a leader in our specialty; it’s been very rewarding. But I’ve always placed huge emphasis on family life and being physically active outdoors. My family and I enjoy travel, skiing, dining out, and sports events and try to do those things together as much as possible.
In closing, I want to make sure that everyone knows that ABEM is celebrating its 40th anniversary this year. Our success as a certifying body is the direct result of the efforts and quality practice of emergency physicians. We believe that ABEM-certified physicians are the best individuals to provide safe, high-quality emergency care.