Resident Rules of the Road: Chapter 1 Summary: “History”

AAEM/RSA is proud to present weekly summaries of our popular publication Rules of the Road for Emergency Medicine Residents. As a multi-part series, these posts address many important topics ranging from the history of emergency medicine to resident wellness and job search suggestions.

Originally Published: AAEM’s Rules of the Road for Emergency Medicine Residents, 7th Ed. Chief Editors: Tom Scaletta, MD FAAEM; Michael Ybarra, MD FAAEM; Leana Wen, MD MSc. AAEM and AAEM/RSA. Milwaukee, WI. 2010.

Chapter Summary By: Puja Gopal, MSIV Medical Student, University of Illinois School of Medicine
Summary Series Editors: Muhammad Alghanem, BS, and Andrew W Phillips, MD MEd
The history of emergency medicine is rich and relatively recent. Below is a brief summary of the emergency medicine (EM) specialty broken down by decades.
1960’s: Emergency medicine evolved out of a need to care for a growing population that sought care for emergency conditions. By 1960, emergency department (ED) visits were rising across the country and the demand for emergency care was high. Physicians, however, lacked the appropriate skills, and there was a need for specialized training. In 1967, the American Medical Association (AMA) established a committee on emergency medicine, and in 1968, the American College of Emergency Physicians (ACEP) was founded.

1970’s: The first university-based EM residency was started at the University of Cincinnati in 1970, and the first community hospital EM residency was established at Evanston Hospital, IL in 1973. The Emergency Medicine Residents Association (EMRA) formed in 1974. In 1975, the forerunner to the Residency Review Committee for Emergency Medicine (RRC/EM) was created. The American Board of Emergency Medicine (ABEM) was incorporated in 1976, and in 1979 EM was finally recognized as a specialty. Osteopaths joined in 1975 when the American College of Osteopathic Emergency Physicians (ACOEP) became an affiliate of the American Osteopathic Association (AOA). The first osteopathic EM residency began in 1979 at the Philadelphia College of Osteopathic Emergency Medicine.
1980s: In 1988, ABEM began to require EM residency training to qualify for the ABEM certification exam. In 1989, EM became a primary board. Also in 1989, the Society for Academic Emergency Medicine (SAEM) formed.
1990s: In 1992, James Keaney published “The Rape of Emergency Medicine,” which explored the corruption in EM and the exploitation of emergency physicians. Certain people in the field were making huge profits based on unfair business practices, such as hiring unqualified emergency physicians willing to work for less pay. This reality triggered the formation of the American Academy of Emergency Medicine (AAEM) in 1993 to promote fair and equitable practice and promote the highest level of patient care.
2000s: There has been a rise in the “corporatization” of the field with a rise in the number of large contract management groups acquiring emergency physician contracts. This is a concerning threat to the field because it can compromise the role of emergency physicians as advocates for all patients, including the under- and uninsured.  
In terms of residency program growth, in 2013, there were 170 allopathic and 49 osteopathic EM residency programs. The resident section of AAEM was formed in 1999 and is known as the AAEM Resident and Student Association (AAEM/RSA). This organization’s primary goals are to advocate for EM residents, build a community, and promote direction and change in the field.
For more information, be sure to look at your copy of AAEM’s Rules of the Road for Emergency Medicine Residents!