Fildes, trauma surgeon from Las Vegas, said that emergency medicine’s conflict is not with surgery. It is with the American Board of Medical Specialties (ABMS). “Surgeons get it. You guys treat critically ill patients every day. What you need is a very specialized curriculum and fellowship training program that focuses on topics like obstetrical emergencies, neonatal, children, cardiac, and renal,” Fildes said. “You don’t get any of that in the surgical critical care program.”

“We understand that you need it, and our house is not the right place to get it,” Fildes continued. “We would support you in approaching [ABMS]. Just be careful of one thing. It is a double-edged sword. You want to end boarding, but you want to set up critical care areas in your emergency centers. You have manpower shortages, but you are trying to get boards and other specialties that create bridges out of your profession. That disconnect will not be viewed favorably across the board. That is the only caution that I add to it.”

Finally, session chair Krohmer asked the panelists to say, in one word if possible, what is the most critical workforce issue in your discipline that we need to address right now? Their responses were as follows:

  • Haley: “ER docs, more of them.”

  • Meredith: “Residents and training slots.”

  • Howard: “Nurses.”

  • Manz: “Partnerships.”

  • Prentiss: “Funding.”


Manz, D. 2009. The EMS Education Agenda for the Future. PowerPoint slide presented at the National Emergency Care Enterprise Workshop, Washington, DC.

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