Reader Responds: Non-ABEM Doctors Deserve Dignity and Respect
By Raj Parikh, MD
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ACEP Now: August 2025 (Digital), ACEP Now: September 2025Regarding your recent interview with ABEM President Dr. Diane Gorgas in ACEP Now, I’d like to share a few thoughts as I think it’s critical to show a different viewpoint. In 1992, I graduated from the University of Texas Southwestern Medical School at Dallas, known for Parkland Hospital. At that time, the hospital had five separate emergency departments, each controlled by its supervising specialty—surgery/trauma, medicine, obstetrics/gynecology, pediatrics, and psychiatry. There were no emergency medicine rotations, much less an emergency medicine residency. Emergency medicine was not promoted as a potential residency or specialty there. After completing two years of general surgery and three years of family medicine residency, I am board certified in family medicine, but I have been practicing emergency medicine for more than 30 years.
From the Editor: The Legacy of the Emergency Physician
By Cedric Dark, MD, MPH, FACEP
Several years ago, two of my colleagues who trained as internal medicine physicians, but who worked in our emergency department, were no longer able to do so after a restructuring that placed residents in each of our clinical areas. It brought to my attention the rule from the Accreditation Council on Graduate Medical Education (ACGME) regarding program requirements for emergency medicine that states that emergency medicine residents can only be supervised by faculty members who have been, or are eligible to be, board-certified by ABEM or AOBEM.1 This rule, which has been in place for many years, is similar to rules for other specialties, but is outside the control of a membership organization such as ACEP.
The specialty of emergency medicine has benefited greatly from legacy emergency physicians, such as yourself, and although ACEP membership has been closed to new non-EM residency–trained physicians since December 31, 1999, many have continued to contribute greatly to the largest and most influential membership organization for our specialty and all have remained welcome within the College.2
Your letter brings up a painful reminder from 2018, when the duly elected president-elect of ACEP, Dr. John Rogers, chose to resign to avoid fragmentation of the specialty—many in the College did not agree that someone who trained as a surgeon should be the elected leader of ACEP.3 Dr. Rogers has been and remains an emergency physician, as are all legacy physicians with ACEP membership.4 ACEP policy, as reaffirmed last year, states that “legacy emergency physicians should not be forced out of the workforce solely on the basis of their board certification status.”5 Thus, I am similarly disheartened to see you and your colleague forced to resign. However, requirements governing who may sit for the emergency medicine boards and who can be faculty at a residency program are outside of ACEP’s purview.
In my interview with Dr. Gorgas, the President of ABEM, my mention of the 10,000-hour rule, popularized by Malcolm Gladwell, is an analogy to the training of elite musicians. I once played the trumpet, but I am no Miles Davis. For anyone who practices an art, including the art of medicine, practice improves performance. Even though it doesn’t make perfect, we continue to practice medicine and aspire for the best for our patients.
This is one reason why the College and its Chapters continue to advocate for a physician—and preferably an emergency physician—in every emergency department; we know that one in 13 do not have one.6 As emergency physicians we believe this provides the best care for our patients and will prevent the wholesale replacement and undervaluing of our specialty by corporate interests of staffing groups and hospitals. As you point out, there is complexity and difficulty with making that aspiration a reality.7 At ACEP Now, we have presented that dynamic and also the perspective of physicians trained in family medicine who work primarily in the rural emergency setting who similarly want to see collaboration, respect, and dignity for our legacy emergency physicians.
Correction: An earlier version of this article incorrectly stated AOBEM as ABOEM.
Dr. Dark (@RealCedricDark) is associate professor of emergency medicine at Baylor College of Medicine and the medical editor in chief of ACEP Now.
References
- Accreditation Council for Graduate Medical Education. Program Requirements, FAQs, and Applications. Accessed July 10, 2025.
- ACEP. Facts about ACEP Fellow Resolution 11(07) and Proposed Resolutions 9(08), 10(08), 11(08) and 12(08). Accessed July 10, 2025.
- Rogers J. Dr. John Rogers Pens Post-Resignation Letter to ACEP Council. ACEP Now. Accessed July 10, 2025.
- ACEP. Definition of an emergency physician. Accessed July 10, 2025.
- ACEP. The role of the legacy emergency physician in the 21st century. Accessed July 10, 2025.
- Scheid D. Research Returns Spotlight to Physician ED Coverage. Accessed July 10, 2025.
- Beresford L. ACEP Takes Firm Stand on Physician Leadership. Accessed July 10, 2025.
For my entire career, I feel that both ACEP and ABEM have disparaged non-ABEM boarded emergency physicians such as myself. Your interview states, “you need to do something 10,000 times to be an expert at it.” Yet, both organizations have convinced hospital administrators across the country that an ABEM-eligible, recent residency graduate is more qualified to work in their emergency department than a multi-year experienced non-ABEM–boarded physician. You also claim that “every patient should have access to an ABEM-certified physician when they come to an emergency department.” However, even in 2025, there are not enough ABEM-certified physicians to staff every emergency department in the United States. In fact, residency vacancies persist in emergency medicine, with 2023 being one of the worst matches in the history of this young specialty.
Thanks to the narrative from both organizations, a colleague and I were forced into “voluntary resignation” by our employer under the guise of not being ABEM-boarded and thus, unqualified to teach emergency medicine residents.
My membership in ACEP has been mandated by employers over the years, but I will not renew my membership this year because it has failed to protect and advocate for a significant minority in the profession, who are held to the same standards as their ABEM-certified colleagues, but are treated as unworthy.
I implore you both, as the representatives of your organizations, to treat our small, but essential, group of physicians with respect and dignity, which we have earned by providing exceptional care to our patients over decades.
Dr. Parikh is a recently retired emergency physician in North Carolina.
2 Responses to “Reader and Editor Respond: Non-ABEM Certified Emergency Physicians”
August 10, 2025
RCIt’s AOBEM, not ABOEM, Dr. Dark.
August 10, 2025
wray anthony gerardThank you both for this excellent discussion. But it’s time to do more than talk about this. It’s been an issue since the 1990’s. (Bullock KA, Gerard WA, Stauffer AR. The emergency medicine workforce and the IOM report: embrace the legacy generation. Ann Emerg Med. 2007 Nov;50(5):622-3. doi: 10.1016/j.annemergmed.2007.05.025. PMID: 17963988.)
It’s time for ACEP to follow Dr. Greg Henry’s recommendation ( sadly, posthumously) and make
ACEP a welcoming organization for ALL emergency physicians. Right now, the only non-ABEM boarded members who feel welcome are Legacy Physicians who were granted FACEP, and international emergency physcians.
Why should a physician from another country, who is non-ABEM boarded, and trained in family medicine be welcomed in ACEP when thousands of US physicians are excluded? Why isn’t ACEP like it’s sister organization in Canada, where EP’s who trained in family medicine ( CCFP-EM) are welcome.
What about the physicians who staff our rural ED’s?(Pawn and King Play: A Stalemate on Rural Emergency Medicine Staffing; Gerad, W. Anthony,J Am Board Fam Med. May-Jun 2019;32(3):292-294. https://www.jabfm.org/content/jabfp/32/3/292.full.pdf )
ACEP et al ( AAEM, SAEM, etc.) are unwelcoming to family physicians who provide emergency care, and workforce models still exclude these non-ABEM docs, even though they are essential to the workforce. The AAFP should just assume that ACEP will remain “ idle” in addressing this issue, and assert our role in providing emergency care. (Gerard WA. Re: National Study on the Contribution of Family Physicians to the US Emergency Physician Workforce in 2020. J Am Board Fam Med. 2021 Nov-Dec;34(6):1265-1266. doi: 10.3122/jabfm.2021.06.210388. PMID: 34772783)