Recommended Musculoskeletal and Sports Medicine Model Curriculum for Emergency Medicine Residency Training.

ABSTRACT: Musculoskeletal and sports medicine conditions are common in the emergency department (ED). Emergency physicians may not be receiving adequate education to achieve clinical competency in musculoskeletal medicine during residency training. This article aims to provide a standardized musculoskeletal and sports medicine curriculum for emergency medicine training. Broad curriculum goals include proficiency in evaluating and managing patients presenting to the ED with acute and chronic musculoskeletal complaints and other medical conditions related to or affected by physical exertion, sports participation, or environmental exposure. Specific objectives focus on knowledge of these disorders, physical examination skills, procedural skills including musculoskeletal ultrasound, appropriate consultation and referral, and patient education for these conditions. Educational methods will consist of didactics; online self-directed learning modules; simulation; and supervised clinical experiences in the ED, primary care sports medicine clinics, and orthopedic clinics if available. Curriculum implementation is expected to vary across programs due to differences in residency program structure and resources.

Consensus Statement- Prehospital Care of Exertional Heat Stroke.

Exertional heat stroke (EHS) is one of the most common causes of sudden death in athletes. It also represents a unique medical challenge to the prehospital healthcare provider due to the time sensitive nature of treatment. In cases of EHS, when cooling is delayed, there is a significant increase in organ damage, morbidity, and mortality after 30 minutes, faster than the average EMS transport and ED evaluation window. The purpose of this document is to present a paradigm for prehospital healthcare systems to minimize the risk of morbidity and mortality for EHS patients. With proper planning, EHS can be managed successfully by the prehospital healthcare provider.

Utility of an automated notification system for recruitment of research subjects.

BACKGROUND: Experience with a novel method of notifying investigators about research subjects in a university-based emergency department (ED) is reported. METHODS: An automated paging system was linked to the electronic medical record to identify inclusion criteria and notify investigators at the time of ED triage. The rate of study enrolment 2 months before and after implementation of the automated system was compared and the time from triage completion to investigator notification was assessed. RESULTS: During the first 2-month period, 1/17 eligible patients were identified by staff. During the second 2-month period, 1/7 eligible patients were identified by staff while the automated paging system recognised 7/7 eligible patients, an absolute increase of 94.5%. The median time from completion of triage to automated notification of investigators was 0 min. CONCLUSION: Automated paging using the electronic medical record has the potential to improve enrolment in clinical research studies by improving the speed and sensitivity of identifying eligible subjects.

Topics to ponder: Part-time practice and pay parity.

BACKGROUND: The medical profession has undergone a significant demographic change, with a dramatic increase in the number of women applying to medical school and practicing medicine. OBJECTIVES: In recognition of the changing demographics in the medical profession, the American Medical Association's Women Physicians Congress (AMA-WPC) conducted a members' survey to identify the issues affecting women physicians and to ascertain certain practice characteristics. METHODS: In 2008, an e-mail survey link was sent to a randomly selected nationwide sample of 4992 WPC members, and a second, identical survey was sent to 596 female AMA members, utilizing the Epocrates database (Epocrates, Inc., San Mateo, California). Two e-mail reminders were sent for the first survey, which had a 15% response rate. A quota of 148 physicians was received within 4 days and was utilized to interpret results from the second survey. RESULTS: Achieving work-life balance was a significant concern for 91% of the respondents (n = 884). Half of the respondents believed that pay is gender neutral, and 28% indicated that they were "somewhat or very concerned about sexual harassment". When queried regarding practice patterns, 29% of respondents indicated that they had worked part-time at some point during their careers. CONCLUSIONS: In this survey, women physicians indicated that gender pay disparity and sexual harassment remain important issues in the medical profession. Less than a third of respondents had ever worked part-time, which should be a consideration for physician workforce studies. Barriers to part-time practice may exist.