Podcasts on the ALiEM Soundcloud account

EM Match Advice: Where did all the jobs go, and did the applicants follow?

In this episode of EM Match Advice, our panel takes on the tough issues of 2021. Specifically we discuss the American College of Emergency Physicians (ACEP) Workforce Study [1] that projects fewer jobs for emergency physicians and the hot-off-the-press ERAS data showing a drop in the number of EM residency applicants, compared to 2 years ago. Did one cause the other? In this podcast, Dr. Mike Gisondi and Dr. Michelle Lin host an esteemed panel of 3 program directors, Dr. Cassandra Bradby (East Carolina University), Dr. Adam Kellogg (Baystate Health), and Dr. Craig Krausz (Saint Louis University).

The Numbers

  • The ACEP Workforce Study projects a whopping 7,845 excess of emergency physicians in 2030 who could be left without jobs. And our very smart medical students have been eyeing those numbers carefully.
  • While EM is still an attractive specialty for many medical students, some enter this year’s residency application season with a trepidation that hasn’t been seen before. And a good deal of  students clearly chose a specialty other than EM, with approximately 200 fewer applicants projected this cycle, compared to 2 years ago. Most of that drop came from students at LCME-accredited medical schools. [Silver lining: These numbers may make for a buyer’s market that greatly favors the students in the upcoming Match.]
  • Below is a summary of the ERAS data, pulled from their downloadable Excel data. Note that these data were collected on October 3 of each year and only summarize data from EM-only residencies (not EM/IM or EM/FM).
Characteristic2016-172017-182018-192019-202020-21*2021-22
Number of EM residency applicants3,2203,3303,3383,601x3,408
Average number of submitted applications in EM49.153.3557.8659.75x61.23
Average of applications received per EM program883.3866.6850.82874.58x772.82
AAMC’s ERAS data for 2016-2022 for the specialty of Emergency Medicine, collected on October 3 of each year
(* Because of the pandemic, the 2020-21 season’s timeline was shifted later by about 1 month, resulting in non-comparable data.)

EM Match Advice Podcast

Additional Resources

Read and Listen to the other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

References

  1. Marco CA, Courtney DM, Ling LJ, et al. The Emergency Medicine Physician Workforce: Projections for 2030 [published online ahead of print, 2021 Aug 2]. Ann Emerg Med. 2021; doi: 10.1016/j.annemergmed.2021.05.029. Epub ahead of print. PMID: 34353653.
By |2021-10-27T09:50:17-07:00Oct 30, 2021|EM Match Advice, Podcasts|

EM Match Advice: Program Directors Reflect on the 2021 Residency Match

How competitive is EM emergency medicine match EM Match Advice

Dr. Mike Gisondi and Dr. Michelle Lin return for their annual review of the most recent Match in emergency medicine (EM) in latest episode of EM Match Advice. They were joined by a panel of 3 outstanding program directors, Dr. Jacob Ufberg (Temple), Dr. Amita Sudhir (University of Virgina), and Dr. William Caputo (Staten Island Medical Center). Was the EM Match more competitive this year? That’s a complicated question and you need to listen to the podcast discussion for the nuanced answer.

The Slide: The Nitty Gritty Annual Numbers of the EM Match

“The Slide” above is a summary of EM Match statistics taken from the annual National Residency Matching Program (NRMP) Data and Results publication over the last 10 years. Trends suggest that EM is becoming less competitive year over year; however, 2021 saw the greatest number of unmatched medical students who were EM bound. What are the most competitive specialties and how does EM compare? Generally, we use the % fill rate with LCME students to determine the competitiveness of a specialty. That is the % of entry-level positions filled by allopathic senior medical students from the US, Puerto Rico, and Canada. Who’s on top this year? Four combined programs that each have very few PGY-1 positions in the match all filled with 100% LCME students: EM-anesthesiology, medicine-anesthesiology, pediatrics-anesthesiology, and pediatrics-PMR. Here’s how a few of the other specialties fared:

  • Thoracic surgery 93.5%
  • Plastic surgery 89.3%
  • Vascular surgery 82.3%
  • Orthopedic surgery 80.5%
  • Obstetrics-gynecology 66.7%
  • Surgery 65.6%
  • Emergency medicine 62.1%
  • Pediatrics 60.3%
  • Radiology 58.2%
  • Internal medicine 39%

Podcast: Program Directors Reflecting on the 2021 EM Residency Match

Read and Listen to the other EM Match Advice Episodes

Blog posts: https://www.aliem.com/em-match-advice-series/

By |2021-07-19T19:27:46-07:00Jul 21, 2021|EM Match Advice, Podcasts|

Education Theory Made Practical: Listen to the New Podcast Series

education theory made practical books into podcast

The Education Theory Made Practical (ETMP) set of 3 e-books were published starting 2017, reviewing key education theory principles and practically framing the abstract into practical scenarios. This series was produced by the ALiEM Faculty Incubator in collaboration with the  International Clinician Educator (ICE) blog. These e-books can be downloaded for free in the ALiEM Library.

We were surprised, humbled, and honored that Dr. Daniel Harper wanted to convert the popular e-books into a podcast series, with each chapter turned into short 10-20 minute podcast. As a pilot test, he converted Volume 1 into a set of 10 podcasts. Take a listen, put on your educator-scholar caps, and let us know what you think.

Podcast Series: Education Theory Made Practical (Volume 1)


Podcast Team

Daniel Harper

Host: Daniel Harper, MD

Senior Resident
Dual Interventional Radiology and Diagnostic Radiology
Ochsner LSU Health Shreveport

Host: Surbhi Raichandani, MD

Senior Resident
Department of Radiology
University of Arkansas Medical Sciences

Guest Voice:

  • Loren James Perley (electrical engineer)

Reference

Chan TC, Gottlieb M, Sherbino J, Boysen-Osborn M, Papanagnou D, Yarris L. Education Theory Made Practical, Volume 1. San Francisco, CA: ALiEM Publishing, 2017. [ISBN 978-0-9992825-0-2, PDF]

By |2021-07-20T06:21:16-07:00Jul 16, 2021|Academic, Medical Education, Podcasts|

EM Match Advice: 2020-21 Interview Season | This is how it started, this is how it’s going

EM Match Advice residency interview season 2020-21

The 2020-21 residency interview season has required rapid innovation and adaptability for both medical student applicants and residency programs, given COVID-19’s physical distancing restrictions. Listen to how it started and how it is going thus far with podcast co-hosts Dr. Michael Gisondi (Stanford) and Dr. Michelle Lin (UCSF).

Podcast episode with 2020-21 mid-season update and insights


Program director panelists

  • Dr. Camiron Pfennig – Prisma Health University of South Carolina Greenville
  • Dr. Ryan Bodkin – University of Rochester
  • Dr. Michael Kiemeney – Loma Linda University

Listen to all the episodes of the EM Match Advice Series

Additional resources

By |2021-07-01T10:16:37-07:00Jan 15, 2021|EM Match Advice, Podcasts|

ACEP E-QUAL: The Electronic ICU

 

eICU

Building on already increasing interest in telehealth, the COVID-19 pandemic accelerated the development and implementation of telemedicine services in a variety of clinical settings. In 2018, Dr. Jason Woods hosted an episode of the ACEP E-QUAL Network podcast highlighting the creation of an electronic intensive care unit (eICU) through Emory Healthcare. In this episode, Dr. Tim Buchman and Critical Care Nurse Cheryl Hiddelson share their innovative approach to delivering critical care services via telehealth. We present highlights from this discussion below.

 

 

What is an eICU?

The eICU allows for critical care oversight, without having to be on site. It provides comprehensive monitoring and data analysis and online audio or video support for patients and families. Utilizing advanced information technology (IT) platforms and approaching with a business strategy, telehealth allows for innovative ways to provide critical care services remotely.

Why is there a need for an eICU?

The US population is aging, with the number of Americans age 65 or older increasing steadily. Demand for critical care services increases with age. The availability of critical care physicians is limited in large areas of the US. Similarly, as more nurses are reaching retirement than those entering the workforce, critical care providers are becoming hard to come by. Recruiting and maintaining critical care providers is only one part of the issue, with staffing on nights, weekends, and holidays creating a constant challenge. Telehealth poses a contemporary solution to the scarcity of healthcare providers.

What does the eICU setup look like?

The eICU is akin to airline control towers. There is 24/7 coverage by nursing and physician staff, overseeing more than a hundred beds. Various screens facilitate a “sentry” role in which surveillance monitoring algorithms allow staff to detect problems possibly even before the bedside staff. The eICU integrates bedside monitor data with additional system-wide data to create different views of what is occurring in the unit being monitored. Staff can track discharge readiness and filter lists by system or condition.

Camera sessions allow for bi-directional communication with patients and families, but also for just-in-time-training with staff as well as consultation with specialists.

What unique challenges has the eICU been able to address?

  • On-site advanced practice providers (APPs) such as physician assistants, nurse-practitioners, can be supervised by critical care nurses and physicians to provide in-person care.
  • Alternative staffing from geographic areas that are in a different time zone can help fill night shifts. The Emory group used travel nurses and physicians who were stationed in Australia.
  • Distance and delay to care become irrelevant when an intensivist can be available 24/7.

What benefits have been observed with the eICU?

The Emory eICU was able to realize decreased mortality, decreased transfer rates, decreased length of stay, and an increase in patient experience metrics for the hospitals it covered compared to other local facilities. Analysis of costs suggested savings of thousands of dollars per patient and increased revenue for small community hospitals that could retain and increase their daily census of critical care patients.

Can this concept be applied to Emergency Medicine?

There may be a role in applying telehealth data monitoring to emergency department waiting rooms in an attempt to identify patients at high risk for sudden deterioration or decompensation.

Interested in more ACEP-EQUAL podcasts?

Listen to the other ACEP E-QUAL podcasts on our Soundcloud account.

Buprenorphine prescribing: The Get Waivered Initiative makes it easier to get your DEA-X Waiver

A major development in curbing the opioid epidemic is the introduction of the medication buprenorphine to address opioid addiction. Being able to prescribe this medication, however, requires a special DEA-X Waiver in the United States. Dr. Alister Martin, the Founder of the Get Waivered initiative, is working to reduce the barriers for clinicians to obtain the training and paperwork necessary to obtain this waiver. Dr. Michelle Lin talks with Dr. Martin on this podcast about the backstory of the Get Waivered program, the lowered barriers to obtaining training, and some sneak peaks on what is new on the launching pad for his program.

Interesting fact: Medical students can participate in the free DEA-X waiver training now. The certificate of completion has no expiration date and can be submitted, when eligible for this waiver license.

Podcast with Dr. Alister Martin on the Get Waivered program

Visit the Get Waivered site to learn of their upcoming online training events and hot off the press news.

Additional Reading

  • A Tale of Two Epidemics: COVID-19 and the Opioid Crisis

ACEP E-QUAL podcasts on the opioid epidemic

  1. Opioid Use Disorder (OUD) Access in the Time of COVID
  2. Transitioning to Outpatient Care in OUD
  3. Substance Use Disorder Chat
  4. Pain Management for Patients with Opioid Use Disorder
  5. Opioid Overdose Prevention & Naloxone Distribution
  6. Opioid Withdrawals & Buprenorphine in the ED
  7. Buprenorphine after Opiate Overdose Part 1
  8. Buprenorphine After Opiate Overdose Part 2
  9. Supercharging Medication Assisted Therapy (MAT) with PAs and APRNs

 

buprenorphine suboxone OUD get waivered

Disclosure: ALiEM is proud to be a collaborator with the Get Waivered Initiative. This work was funded by the Foundation for Opioid Response Efforts (FORE). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies or stance, either expressed or implied, of FORE. FORE is authorized to reproduce and distribute reprints for Foundation purposes notwithstanding any copyright notation hereon.

By |2020-11-30T14:11:47-08:00Dec 2, 2020|Podcasts, Tox & Medications|
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