From ACEP's Workforce Section newsletter.....
Timeline:
ACEP and the “Section on Certification and
Emergency Medicine Work Force”
February 2008
Compiled by Arlen R. Stauffer, MD, MBA, FACEP
1969 – ACEP members agree to pursue specialty status.
1974 – Committee on Board Establishment (COBE) developed to set up ABEM.
1975 – COBE and ACEP agree to establish “practice track”.
1977 – Rejection of ABEM by American Board of Medical Specialties (ABMS).
1979 – ABEM clarifies that “practice track” will remain open for 8 years;
· September 21: ABMS approves ABEM as “modified conjoint board” (thus enabling ABEM
eligibility for “practice track” candidates without any certification or residency training in
other sponsoring boards’ specialties). ABEM votes to not extend deadline for closure of
“practice track”.
1987 – ACEP and ABEM agree that “practice track” deadline will not be changed.
1988 – “Practice track” closes.
1989 – ABMS approves ABEM’s application for Primary Board status.
1990 – “Academic Internist practice track” opens.
1990 – Gregory F. Daniels, MD v. ABEM, filed in New York.
1991 – ACEP’s Task Force on Manpower proposes “alternative residency program”; rejected
by ABEM committee.
1992 – ABEM elects to keep “practice track” closed; additional discussions regarding
“alternative residency programs” (no action taken).
1993 – ACEP “Section of Certification Process and Implications for Emergency Medicine”
approved by ACEP Board.
1993 – Code of Federal Guidelines – Medicare: “…under no circumstances is the accordance
of staff membership or professional privileges…dependent solely upon certification”.
1993 – A group of ACEP members and other emergency physicians form the Association of
Emergency Physicians to represent their interests; AEP was open to all EPs regardless of
training or certifications.
1994 – ACEP Board adopts “Criteria for Recognizing Certifying Bodies in Emergency
Medicine” policy; only ABEM fulfills all criteria. Preliminary discussions held between ACEP
and AAPS (BCEM) representatives; Point # 8 of the criteria requires completion of an EM
residency, but adds “this criterion is not intended to prevent recognition to boards that have
special categories that enable a limited number of individuals to access the examination
under special circumstances.”
1994 – ACEP Council narrowly rejects “practice track type” Fellowship criteria, falling just
short of the required two-thirds majority for Bylaws changes.
1995 – ACEP’s “expert witness” criteria require EM certification.
1995 – AMA: “board certification should not be utilized as a minimum or sole criterion” for
assessing physician competency.
1995 – ACEP Council accepts the Board resolution that “no single criterion” alone should be
used to assess an EP.
1995 – ACEP Council again rejects ACEP Fellowship without ABEM certification (rejected this
time by a wider margin).
1996 – Fellowship Task Force offers Fellowship Resolution – rejected.
1996 – Fellowship Task Force also offers language creating “Career Recognition Award” –
adopted by Council but became meaningless as very few ACEP members applied for the
Award.
1998 – ACEP recognizes AOBEM.
2000 – Certification Section membership census struggles above 250.
2000 – ACEP Board approves “Recognition of Certifying Bodies in Emergency Medicine”; this
eliminates the prior “criteria” and now relies on the “highly respected umbrella
organizations” (ABMS and AOA), but includes the asterisk statement:
** “ACEP acknowledges that there exists a non-ABMS and a non-AOA certifying body, the
Board of Certification in Emergency Medicine (BCEM), that may allow emergency physicians
who do not meet existing training standards of ABEM or AOBEM to present themselves for
evaluation and testing in the clinical content of emergency medicine and achieve
certification based on specified criteria. This ACEP policy is not intended to pass judgment
on the work of BCEM.”
2001 – ACEP representative quietly presents ACEP’s official “Recognition of Certifying
Bodies” policy to the Florida Board of Medicine; the Florida BOM votes to officially recognize
the BCEM.
2002 – ACEP Board adopts “ACEP Recognized Certifying Bodies in Emergency Medicine”
policy, now with no mention of the BCEM. The “is not intended to pass judgment on the work
of BCEM” statement is now gone from official ACEP language.
2003 – U.S. District judge grants ABEM’s motion to dismiss the Daniels v. ABEM suit.
Plaintiffs appeal to second Circuit Court of Appeals, which upholds the District Court ruling in
2005, finally ending the suit (15 years after its initial filing).
2003 – ACEP frequently uses the EP’s-“who-started-work-in-the-20th-Century” criterion, and
it becomes a common communication tool….
2004 – ACEP Board agrees to grant a one-year dues Holiday for all eligible Cert Section
members.
2004 – ACEP and AAEM provide active opposition to recognition of the BCEM in Florida and
elsewhere. The Florida BOM decides to continue recognizing the BCEM, allowing Florida
doctors certified by this board to call themselves “board-certified”.
2005 – The Certification Section list-serve comes to life…
2005 – Fellowship resolution submitted by this Section is withdrawn after Council Reference
Committee testimony was predominantly negative (in spite of vocal support from Drs. Suter
and Blum, and from six Certification Section members in attendance).
2006 – ACEP publishes its first “Report Card”, insulting many “Legacy” EPs, and leading to
the January 24, 2007 letter of apology from Dr. Blum.
2006 – ACEP Board adopts new policy: “The Role of the Legacy Emergency Physician in the
21st Century”, supported by this Section.
2006 – Institute of Medicine Report includes supportive language (for Legacy EPs) in its
workforce discussions, but this topic was not discussed in the multiple August 2006 Annals
of Emergency Medicine articles addressing the IOM Report.
2006 – Certification Section’s membership decreases to 700 + (from its high of 2200 during
the 2005 dues Holiday); the majority elect to not renew their $35 Section membership in 2006.
2007 – Fellowship Task Force (included three Section members) provides its report,
encouraging ACEP to consider separating the issues of board certification and Fellowship,
and failing to find any significant negatives associated with offering Fellowship to Legacy EPs.
2007 – ACEP Council passes the new Fellowship Resolution (again, from this Section) with an
overwhelming majority, opening the way for Legacy EPs meeting several strict criteria to
attain Fellowship within ACEP.
2007 – Section changes its name to “Section on Certification and Emergency Medicine Work
Force” at the annual meeting after the 2007 ACEP Council meeting.
2008 – Nearly 100 Legacy EPs attain ACEP Fellowship status in January and February.
2008 – Legacy EPs (current Section members) are members of the new ACEP Workforce
Task Force and the new ACEP Report Card Task Force.
{This list is not complete. The dates and activities recorded herein are correct to the best
recollection and estimation of the author and his records, although some dates could
certainly be incorrect. Readers are encouraged to submit additions and corrections to the
author at arlen@arlenstauffer.com . ARS}
ACEP and the “Section on Certification and
Emergency Medicine Work Force”
February 2008
Compiled by Arlen R. Stauffer, MD, MBA, FACEP
1969 – ACEP members agree to pursue specialty status.
1974 – Committee on Board Establishment (COBE) developed to set up ABEM.
1975 – COBE and ACEP agree to establish “practice track”.
1977 – Rejection of ABEM by American Board of Medical Specialties (ABMS).
1979 – ABEM clarifies that “practice track” will remain open for 8 years;
· September 21: ABMS approves ABEM as “modified conjoint board” (thus enabling ABEM
eligibility for “practice track” candidates without any certification or residency training in
other sponsoring boards’ specialties). ABEM votes to not extend deadline for closure of
“practice track”.
1987 – ACEP and ABEM agree that “practice track” deadline will not be changed.
1988 – “Practice track” closes.
1989 – ABMS approves ABEM’s application for Primary Board status.
1990 – “Academic Internist practice track” opens.
1990 – Gregory F. Daniels, MD v. ABEM, filed in New York.
1991 – ACEP’s Task Force on Manpower proposes “alternative residency program”; rejected
by ABEM committee.
1992 – ABEM elects to keep “practice track” closed; additional discussions regarding
“alternative residency programs” (no action taken).
1993 – ACEP “Section of Certification Process and Implications for Emergency Medicine”
approved by ACEP Board.
1993 – Code of Federal Guidelines – Medicare: “…under no circumstances is the accordance
of staff membership or professional privileges…dependent solely upon certification”.
1993 – A group of ACEP members and other emergency physicians form the Association of
Emergency Physicians to represent their interests; AEP was open to all EPs regardless of
training or certifications.
1994 – ACEP Board adopts “Criteria for Recognizing Certifying Bodies in Emergency
Medicine” policy; only ABEM fulfills all criteria. Preliminary discussions held between ACEP
and AAPS (BCEM) representatives; Point # 8 of the criteria requires completion of an EM
residency, but adds “this criterion is not intended to prevent recognition to boards that have
special categories that enable a limited number of individuals to access the examination
under special circumstances.”
1994 – ACEP Council narrowly rejects “practice track type” Fellowship criteria, falling just
short of the required two-thirds majority for Bylaws changes.
1995 – ACEP’s “expert witness” criteria require EM certification.
1995 – AMA: “board certification should not be utilized as a minimum or sole criterion” for
assessing physician competency.
1995 – ACEP Council accepts the Board resolution that “no single criterion” alone should be
used to assess an EP.
1995 – ACEP Council again rejects ACEP Fellowship without ABEM certification (rejected this
time by a wider margin).
1996 – Fellowship Task Force offers Fellowship Resolution – rejected.
1996 – Fellowship Task Force also offers language creating “Career Recognition Award” –
adopted by Council but became meaningless as very few ACEP members applied for the
Award.
1998 – ACEP recognizes AOBEM.
2000 – Certification Section membership census struggles above 250.
2000 – ACEP Board approves “Recognition of Certifying Bodies in Emergency Medicine”; this
eliminates the prior “criteria” and now relies on the “highly respected umbrella
organizations” (ABMS and AOA), but includes the asterisk statement:
** “ACEP acknowledges that there exists a non-ABMS and a non-AOA certifying body, the
Board of Certification in Emergency Medicine (BCEM), that may allow emergency physicians
who do not meet existing training standards of ABEM or AOBEM to present themselves for
evaluation and testing in the clinical content of emergency medicine and achieve
certification based on specified criteria. This ACEP policy is not intended to pass judgment
on the work of BCEM.”
2001 – ACEP representative quietly presents ACEP’s official “Recognition of Certifying
Bodies” policy to the Florida Board of Medicine; the Florida BOM votes to officially recognize
the BCEM.
2002 – ACEP Board adopts “ACEP Recognized Certifying Bodies in Emergency Medicine”
policy, now with no mention of the BCEM. The “is not intended to pass judgment on the work
of BCEM” statement is now gone from official ACEP language.
2003 – U.S. District judge grants ABEM’s motion to dismiss the Daniels v. ABEM suit.
Plaintiffs appeal to second Circuit Court of Appeals, which upholds the District Court ruling in
2005, finally ending the suit (15 years after its initial filing).
2003 – ACEP frequently uses the EP’s-“who-started-work-in-the-20th-Century” criterion, and
it becomes a common communication tool….
2004 – ACEP Board agrees to grant a one-year dues Holiday for all eligible Cert Section
members.
2004 – ACEP and AAEM provide active opposition to recognition of the BCEM in Florida and
elsewhere. The Florida BOM decides to continue recognizing the BCEM, allowing Florida
doctors certified by this board to call themselves “board-certified”.
2005 – The Certification Section list-serve comes to life…
2005 – Fellowship resolution submitted by this Section is withdrawn after Council Reference
Committee testimony was predominantly negative (in spite of vocal support from Drs. Suter
and Blum, and from six Certification Section members in attendance).
2006 – ACEP publishes its first “Report Card”, insulting many “Legacy” EPs, and leading to
the January 24, 2007 letter of apology from Dr. Blum.
2006 – ACEP Board adopts new policy: “The Role of the Legacy Emergency Physician in the
21st Century”, supported by this Section.
2006 – Institute of Medicine Report includes supportive language (for Legacy EPs) in its
workforce discussions, but this topic was not discussed in the multiple August 2006 Annals
of Emergency Medicine articles addressing the IOM Report.
2006 – Certification Section’s membership decreases to 700 + (from its high of 2200 during
the 2005 dues Holiday); the majority elect to not renew their $35 Section membership in 2006.
2007 – Fellowship Task Force (included three Section members) provides its report,
encouraging ACEP to consider separating the issues of board certification and Fellowship,
and failing to find any significant negatives associated with offering Fellowship to Legacy EPs.
2007 – ACEP Council passes the new Fellowship Resolution (again, from this Section) with an
overwhelming majority, opening the way for Legacy EPs meeting several strict criteria to
attain Fellowship within ACEP.
2007 – Section changes its name to “Section on Certification and Emergency Medicine Work
Force” at the annual meeting after the 2007 ACEP Council meeting.
2008 – Nearly 100 Legacy EPs attain ACEP Fellowship status in January and February.
2008 – Legacy EPs (current Section members) are members of the new ACEP Workforce
Task Force and the new ACEP Report Card Task Force.
{This list is not complete. The dates and activities recorded herein are correct to the best
recollection and estimation of the author and his records, although some dates could
certainly be incorrect. Readers are encouraged to submit additions and corrections to the
author at arlen@arlenstauffer.com . ARS}