Emergency Physician Statistics- (Sept 2001)
Information from Emergency Physicians' Monthly newspaper; Vol.8, No.9;
Sept.2001; p.19 (Katz Report) reporting on the ACEP E manpower study
- ACEP Statistics
- ~32,000 EP's in USA currently
- ~17,300 are ABEM boarded
- ~1,078 are AOBEM boarded
- <12,500 are EM residency trained
- ~13,622 EP's in practice currently are not ABEM or AOBEM boarded
- ~19,500 are not EM-residency trained (~61%)
Given these numbers:
Status of BCEM certification-
In February 2002, the Florida Board of Medicine made a specific finding of fact that AAPS:
. . . is a legitimate and bona fide organization, whose specialty certification boards have been providing recognition to allopathic and osteopathic physicians for over fifty years. In order to obtain specialty certification, licensed physicians must meet rigorous requirements of the appropriate certification board. Eligibility requires advanced training, significant experience, good moral character and successful completion of a specialty examination. In addition, in order to maintain such certification, every physician is required to complete recertification every eight (8) years.
The Florida Board of Medicine ultimately concluded that AAPS should be granted approval as a specialty recognizing agency. As a result of the Board of Medicines action, any AAPS allopathic board certified Diplomate may now hold himself or herself out to the public in Florida as a board certified specialist.
Commonly Touted Myths-
- Myth: ABEM (or AOBEM) - certified physicians provide a higher quality of care than
non-ABEM/non-AOBEM-certified emergency physicians.
Reality: There are no valid studies that demonstrate a difference in outcomes between those with ABEM/AOBEM certification (including those with emergency medicine residency training) and those denied access to these exams, but who are practicing high-quality emergency medicine.
- Myth: ABEM/AOBEM-certified physicians reduce the risk of malpractice claims against
Reality: There is no evidence to support this notion either. Generally, practice experience plays a more important role in ensuring quality patient care than any limited specialty certification test. (For example, the ABEM exam is required once every 10 years, and BCEM is required once every 8 years in ordered to retain certification. That is why many groups/organizations are moving towards the idea of Continuous Certification, including methods of Practice Assessment.)
- Myth: There is a shortage of ABEM-certified physicians, thus justifying their higher
salaries (compared to non-ABEM-certified physicians).
Reality: The shortage of ABEM-certified physicians is artificial, created by the closure of the practice track (quite prematurely). This shortage has increased the real and perceived value of these physicians and may be in violation of the Sherman Antitrust Act (see Daniel et al. v. ABEM et al. Civil Action No. 90-1086A, U.S. District Court for Western District of New York). In addition, funding for EM residencies has decreased, resulting in less EM-residency trained physicians graduating annually. EM-residencies are not given the same funding for a physician who has had a previous residency (as they do for obtaining residents fresh out of medical school), making it very difficult for a practicing physician to obtain a spot in an EM residency. There are several EM fellowships available in the US (primarily for family physicians), but these are quite limited. Add to this that anecdotally, many physicians in practice will testify that many of the best EPs in practice in their hospital EDs are not those that are EM-residency trained or board certified in EM.
- Myth: Physicians who are not EM-residency trained or ABEM/AOBEM-certified are
Reality: Surveys of non-ABEM/AOBEM certified EPs have shown an average of 10 years of full-time ED experience. (Many of these EPs are not certified by ABEM because they have not been allowed to sit for the exam.)
Other Interesting Information-
- The ABEM practice track (which no longer exists) required 7,000 hours and 60 months of emergency medicine practice (including 24 continuous months of EM practice) and 50 CME hour each year in practice.
- The BCEM exam requires (amongst other criteria) completion of an Emergency Medicine Residency -or- completion of a residency in a primary care specialty, practice of Emergency Medicine on a full-time basis for five (5) years (=60 months), and accumulation of a minimum of 7,000 hours in the practice of Emergency Medicine. [For an excellent comparison of the criteria for the three emergency medicine board exams available, see the ABPSGA web site at http://www.abpsga.org/certification/boc_comparison.html.
- AEP Fellowship Criteria include practice and/or teaching of Emergency Medicine for a minimum of 60 months total; and accumulated 7,000 hours total in the practice and/or teaching of Emergency Medicine; and accumulated 2,800 hours consecutively within any 24-month period of time; confining ones practice to Emergency or Urgent Care Medicine; accumulation of 150 hours of CME credit within the previous three years of practice that is acceptable to the Fellowship Committee; and a demonstration of commitment to Emergency Medicine by active involvement in various ways. [For full AEP Fellowship Criteria, please contact the AEP Office, or see the Members-Only section.]