PLEASE NOTE: THIS RESOLUTION WILL BE DEBATED AT THE 2010 COUNCIL MEETING. RESOLUTIONS ARE NOT
OFFICIAL UNTIL ADOPTED BY THE COUNCIL AND THE BOARD OF DIRECTORS (AS APPLICABLE).
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RESOLUTION:
25(10)
SUBMITTED BY:
Texas College of Emergency Physicians
SUBJECT:
Definition of an Emergency Physician
PURPOSE:
Defines an emergency physician as someone who has either completed ACGME or AOA
residency training in emergency medicine or a fellowship in pediatric emergency
medicine, or who is ABEM or AOBEM certified in emergency medicine or pediatric
emergency medicine, or who is a member of the College.
WHEREAS, ACEP’s policy is that the only acceptable pathway to enter the practice of emergency
medicine in the 21st century and beyond is successful completion of an Accreditation Council for Graduate
Medical Education (ACGME) or American Osteopathic Association (AOA) approved Emergency Medicine
Residency; and
WHEREAS, Physicians who have not completed an ACGME or AOA approved Emergency Medicine
residency are not eligible to enter certification pathways offered by the American Board of Emergency Medicine
(ABEM) or the American Osteopathic Board of Emergency Medicine (AOBEM) that would enable them to be
recognized as specialists in Emergency Medicine; and
WHEREAS, From the very beginning of the specialty of emergency medicine, ACEP asserted that
emergency medicine is defined by our body of knowledge and not the location of our practice; and
WHEREAS, The location of practice does not define the identity of any other ABMS or AOA approved
specialty, or define inclusion of them as practicing the specialty; and
WHERAS, Physicians of other specialties who either regularly or occasionally provide emergency care to
patients are most accurately described as “(other specialty) physicians or surgeons” providing emergency care;
and
WHEREAS, ACEP’s fiduciary duty is to its members and potential members, and definitions of
emergency physicians that include advocating for persons who are not eligible for membership are inconsistent
with this duty; and
WHEREAS, Physicians who began practice in the 21st century who have not completed an ACGME or
AOA approved Emergency Medicine residency are not eligible for ACEP membership; therefore be it
RESOLVED, That ACEP defines an “emergency physician” as someone who has either completed
ACGME or AOA residency training in Emergency Medicine or fellowship in Pediatric Emergency Medicine, or
is ABEM or AOBEM certified in Emergency Medicine or Pediatric Emergency Medicine, or is a member of the
American College of Emergency Physicians.
Background
The resolution calls for ACEP to define an emergency physician as someone who has either completed ACGME
or AOA residency training in emergency medicine, or a fellowship in pediatric emergency medicine, or who is
Resolution 25(10) Definition of an Emergency Physician
Page 2
ABEM or AOBEM certified in emergency medicine or pediatric emergency medicine, or who is a member of the
College.
The only definition of an emergency physician in current ACEP policy is found in the policy statement “Physician
Credentialing and Delineation of Clinical Privileges in Emergency Medicine,” which contains relevant language
that was also adopted in Resolution 51(95) Criteria for Assessment of EPs. The pertinent paragraph in the policy
statement declares: “a qualified emergency physician is defined as one who possesses emergency medicine
training of sufficient experience in emergency medicine to evaluate and manage all patients who seek emergency
care. ACEP believes that the ED medical director should be responsible for assessing and making
recommendations to the hospital’s credentialing body related to the qualifications of emergency physicians with
respect to the clinical privileges granted to them. At a minimum, those applying for privileges as emergency
physicians should be eligible for ACEP membership. Board certification by ABEM or AOBEM is an excellent
but not the sole benchmark for decisions regarding an individual's ability to practice emergency medicine. Other
qualifications may include objective measurement of care provided, sufficient experience, prior training, and
evidence of continuing medical education.”
The existing definition refers to a minimum requirement that emergency physician privileges should be reserved
for those who are eligible for ACEP membership. According to ACEP’s active membership eligibility
requirements delineated in the Bylaws Article IV – Membership, Section 2.1 – Active Members: “All active
members must meet one of the following criteria: 1) Satisfactory completion of an emergency medicine residency
program accredited by the Accreditation Council on Graduate Medical Education (ACGME); 2) Satisfactory
completion of an emergency medicine subspecialty training program accredited by ACGME; 3) Satisfactory
completion of an emergency medicine residency training program accredited by the American Osteopathic
Association (AOA); 4) Satisfactory completion of an emergency medicine residency program approved by an
ACEP-recognized accrediting body in a foreign country; 5) Certification by an emergency medicine certifying
body recognized by ACEP; or 6) Eligibility for Active or International membership in the College at any time
prior to close of business December 31, 1999.”
ABEM and AOBEM are the only primary emergency medicine certifying bodies recognized by the College, as
outlined in the policy statement “ACEP Recognized Certifying Bodies in Emergency Medicine.” (The policy also
recognizes the American Board of Pediatrics as an ABMS certifying body in pediatrics, which provides a
certificate of added qualifications for pediatricians in the subspecialty of pediatric emergency medicine.) Further,
ACEP has also adopted the policy statement, “The Role of the Legacy Emergency Physician in the 21st Century,”
which states that “ACEP believes that physicians who begin the practice of emergency medicine in the 21st
century must have completed an accredited emergency medicine residency training program and be eligible for
certification by ABEM or AOBEM.”
While ABEM and AOBEM have required residency training in emergency medicine for more than 20 years,
physicians certified in emergency medicine through the Board of Certification in Emergency Medicine (BCEM)
are not required to complete an emergency medicine residency training program. BCEM certifies physicians who
complete a residency in another specialty that is determined by BCEM to provide substantial and identifiable
training in emergency medicine and who have practiced emergency medicine on a full-time basis for five years,
accumulating a minimum of 7,000 hours in the practice of emergency medicine. BCEM certification can also be
earned through completion of a 12- or 24-month emergency medicine graduate training fellowship program
approved by BCEM, but physicians completing a 12-month program must also practice full-time in emergency
medicine for an additional 12 months before being qualified for certification.
In October 2000, ACEP adopted the policy statement “Recognition of Certifying Bodies in Emergency
Medicine,” which outlined the criteria ACEP applied in recognizing certifying bodies in emergency medicine.
The criteria specified that the certifying bodies must be approved within the ABMS or AOA structures. The
policy statement included a paragraph stating that “ACEP acknowledges that there exists a non-ABMS and a nonAOA 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
Resolution 25(10) Definition of an Emergency Physician
Page 3
criteria. This ACEP policy is not intended to pass judgment on the work of BCEM.” The policy statement was
allowed to sunset in October 2006.
Physicians certified by BCEM who have not completed an emergency medicine residency and who are not
eligible for ACEP membership would not meet the definition of an emergency physician as contemplated by this
resolution.
ACEP Strategic Plan Reference
Goal 2: Improve Quality, Patient Safety, and Efficiency – Objective 9: Increase the number of emergency
medicine residency-trained practicing physicians
Fiscal Impact
The resolution could be formatted into a policy statement. The costs for printing and distribution of policy
statements are included in the annual budget. Additional dues revenue could be anticipated if adoption of this
resolution is viewed favorably by emergency physicians who are not currently members. Conversely, dues
revenue could be lost if the resolution is viewed negatively by some current members or those who are currently
eligible for membership but have chosen not to join at this time.
Prior Council Action
Amended Resolution 15(09) Emergency Medicine Workforce Solutions adopted. It directed ACEP to investigate
broadening access to ACGME or AOA accredited emergency medicine residency programs to physicians who
have previously trained in another specialty.
Resolution 38(98) Recognition of Certifying Bodies adopted. It directed the Board of Directors to review prior
actions on recognition of certifying bodies in emergency medicine.
Resolution 51(95) Criteria for Assessment of EPs adopted. The resolution stated: “ACEP believes that multiple
criteria can be used to assess the professional competency and quality of care provided by individual emergency
physicians. These include professional credentials such as board certification, objective measurement of care
provided, experience, prior training, and evidence of continuing medical education (CME). In general, no single
criterion should provide the sole basis for decisions regarding an individual’s emergency medicine practice.”
Resolution 37(94) Criteria for Certifying Bodies and Recognition of the BCEM defeated. It called for ACEP to
meet with leaders of BCEM to obtain the necessary information to consider recognition of the BCEM and for
ACEP to adopt the “Criteria for Recognition of Certifying Bodies” with amendments that would allow ACEP to
grant similar recognition and/or acknowledgement of BCEM.
Resolution 35(94) Certifying Boards defeated. It called for rescinding current ACEP policies regarding certifying
boards and that the College reaffirm its ongoing support for ABEM by continuing its role as a parent organization,
while acknowledging that other certifying boards exist.
Resolution 33(93) Recognition of Certifying Bodies in Emergency Medicine adopted. It directed ACEP to study
the implications and possible criteria for College recognition of certifying bodies in emergency medicine.
Amended Resolution 32(88) Recognition of the American Osteopathic Board of Emergency Medicine adopted.
The resolution acknowledged the American Osteopathic Board of Emergency Medicine as a certifying body for
osteopathic emergency physicians.
Resolution 39(87) American Osteopathic Board of Emergency Medicine. The resolution acknowledged the
American Osteopathic Board of Emergency Medicine as a certifying body for osteopathic emergency physicians.
The resolution was defeated by the Board in November 1987.
Resolution 25(10) Definition of an Emergency Physician
Page 4
Substitute Resolution 47(79) adopted. It recognized and supported ABEM as the sole certifying body for
emergency medicine.
Prior Board Action
Amended Resolution 15(09) Emergency Medicine Workforce Solutions adopted.
Approved policy statement “Guidelines for Delineation of Clinical Privileges in Emergency Medicine,” April
1985; revised June 1991; revised with new title, “Physician Credentialing and Delineation of Clinical Privileges
in Emergency Medicine,” September 1995; reaffirmed October 1999; revised June 2004; revised June 2006.
June 2006, approved the policy, “The Role of the Legacy Emergency Physician in the 21st Century.”
October 2001, approved policy, “Recognition of Certifying Bodies in Emergency Medicine”; sunsetted October
2006.
September 2000, rescinded the policy statement “ACEP Criteria for Recognizing Certifying Bodies in Emergency
Medicine” and supported development of a new policy acknowledging that ACEP has no criteria for recognizing
certifying bodies and will only recognize certifying bodies approved by ABMS or AOA.
Resolution 38(98) Recognition of Certifying Bodies adopted.
Approved the policy, “ACEP Recognized Certifying Bodies in Emergency Medicine,” March 1998; reaffirmed
October 2002 and October 2008.
Resolution 51(95) Criteria for Assessment of EPs adopted.
September 1994, approved the policy, “Criteria for Recognition of Board Certifying Bodies in Emergency
Medicine.”
Resolution 33(93) Recognition of Certifying Bodies in Emergency Medicine adopted.
Resolution 32(88) Recognition of the American Osteopathic Board of Emergency Medicine adopted.
November 1987, Resolution 39(87) American Osteopathic Board of Emergency Medicine defeated.
Substitute Resolution 47(79) adopted.
Background Information Prepared By: Craig Price, Chapter & State Relations Director
Reviewed By: Arlo F. Weltge, MD, FACEP, Speaker
Marco Coppola, DO, FACEP, Vice Speaker
Dean Wilkerson, JD, MBA, CAE, Council Secretary and Executive Director