Lessons Learnt from

Implementing
EM as a specialty
Personal Views

Gautam G. Bodiwala,

CBE, DL
DSc (Hon), MS, FRCS, FRCP, FCEM, FIFEM

President
International Federation for Emergency Medicine

Confession
Man is natures sole mistake
Princess Ida (1884) act 2

First Casualty Department Opened in 1869

at St Bartholomews Hospital

THE PLATT COMMITTEE

ESTABLISHED in 1962
TO INVESTIGATE ARRANGEMENTS IN
HOSPITALS FOR RECEPTION AND
TREATMENT OF ACCIDENT
PATIENTS
Very little went to casualty in those
days in the form of Acute Medicine

THE PLATT REPORT

Standard poor and morale low

Accident Surgery can not provide
satisfactory career
Casualty Departments should be renamed
Accident and Emergency Departments

How wrong was Platt regarding career in

Accident Surgery!

Casualty Surgeons Association

The Senior Medical Officers working in
Casualty Department were so incensed
that they established the Casualty
Surgeons Association on 12th October
1967.
OBJECTS:
To promote for the public, high standards in
Science and art of Casualty Medicine and
Surgery

FROM CAS TO A&E TO EM

1967 Casualty Surgeons Association (CSA)
1972 First experimental consultants appointed
1975 SAC in Accident and Emergency Medicine
1977 First Senior Registrar appointed
1983 FRCSEd (A&E) started
1986 First International Conference on Emergency
Medicine, London
1990 First Professorial Appointment
1990 CSA became British Association for Accident
and Emergency Medicine (BAEM)
1991 International Federation for Emergency Medicine
1993 Faculty of Accident and Emergency Medicine

FROM CAS TO A&E TO EM (Contd.)

1996 FFAEM (Exit Examination) Started
2003 MFAEM (Entry Examination) started
2005 Name changed to Emergency Medicine
2005 British Association for Emergency Medicine
2006 International examinations started
2006 Faculty of Accident and Emergency Medicine
became College of Emergency Medicine(CEM)
2006 Merger Board established to create a merged
College of CEM and BAEM
2008 The College of Emergency Medicine

Points to ponder

Name
Type of Organisation
Training Programme/Curriculum
Assessment
Relations with other Specialties/Colleges
Relation with Government and Politics
Lessons from other Nations
Lessons from other Specialties
International Perspective
Creating a profile/Public image

Whats in a name? That which we call rose

by any other name would smell as sweet
Shakespeare

Maurice Ellis Lecture

From Cas. to A & E to EM
Tom Hamilton
First President ACEM

at CSA Annual Conference

Maurice Ellis Memorial Lecture 1989

Name

Casualty Surgeons Association

British Association for Accident and
Emergency Medicine
Faculty of Accident and Emergency
Medicine
British Association for Emergency
Medicine
The College of Emergency Medicine

EMERGENCY MEDICINE
The name Emergency Medicine gives

Identity

Dignity

Creates right public image

Describes its function

Type of Organisation

EM trained Physicians only

ED Physicians only
EM trained Physicians and Nurses
All Physicians, Nurses, Paramedics
etc. interested in EM care
Association, Academy, Faculty or
College?

Training Programme and

Curriculum

Specialist Advisory Committee in Accident

and Emergency Medicine (1975)
Joint Committee in of Higher Training in
Accident and Emergency Medicine (1993)
Training Standards Committee (2008)

Training Programmes according to your

needs

Entry and Assessment

Determine who can enter the training
programme and what is the final
assessment?

1983 FRCS (A&E) RCSEd

1993 (Exit) FFAEM
Pre 2003 (Entry) FRCS (A&E), First Part of
MRCP, FRCS, FRCA
2003 (Entry) MFAEM
2005 MCEM and FCEM
In training Assessment

Government and Politics

Emergency Medicine is recognised and

valued as an essential public service
ACEP Vision Statement

Definition
POLITICS
Science and Art of Public Affairs
Oxford Dictionary

Politics is a process by which people

take decisions on who gets what,
when, why, how?

Inter phase of EM and PH

In Public Health Issues, how do we
influence Government and
legislations?

ACEP Washington DC
CEM (BAEM/FAEM) Clinical advisor to
Department of Health
Inviting Health Ministers/CMO to
conferences

Relations with other specialties

Acute Medicine
Paediatrics
Anaesthesia and Intensive care
Trauma orthopaedics
Public Health etc.

EM in developed countries
performed in two ways

Anglo American Model

Skilled EDs
Pre hospital EMS with paramedics
Franco German Model
Highly developed pre hospital EP
system
But basic hospital based EM in Europe

International Perspective

Geographical
Cultural
Disease/ case mix related

Creating a profile for EM

Early Access
Medical help
Early intervention
Resuscitation
Govern (manage)
Evaluation
Networking
Cooperation (and Communication)
Yes-will do it

Media and Public perception

Casualty
ER
City Hospital
Holby City
Chicago Hope
Cardiac Arrest

Learn from experience

One who makes no mistakes, does
not usually make any thing.
Edward John Phelps (1889),
American Lawyer and Diplomat