EDExam has exploded over the last 2 years, well beyond my wildest imagination, and has outgrown the fairly simple platform I built it on.  The site wasn't built to handle over 1200 members, and a couple of thousand hits a month, so I'm therefore performing a serious overhaul of the site this week.

While this is happening I have disabled the ability to sign up as a member.  People who have already signed up can still access the members only content, however no new memberships will be taken this week. This is to ensure no-one is lost in the transition process to the new, updated site.

If you want to sign up, check back at the end of this week, and hopefully we'll be back online with a snazzier, slicker more functional site then.

If you have any problems with the site, feel free to email me via the Contact page.

Andy

Over at Emergency Trauma Management Amit & I have been busy putting together a new blog and podcast that covers the Emergency Department management of trauma, as a free open access educational component of the ETM Course.  April seems to be "trauma airway month", with a couple of great surgical airway videos to check out on the blog, and the first episode of the podcast starring Minh Le Cong (from prehospitalmed.com and the world-famous PHARM podcast) talking about trauma airways.  Please leave us a comment on the ETM site if you like the blog/podcast, register your interest for a position on the course on our contact page (due for launch late 2013), and give us a 5-star rating on iTunes if you lke the podcast (link below), and there's more episodes coming soon!

Emergency Medicine Revision Notes, put online by Dr Adrian Bonsall, is a great free resource for those sitting the ACEM Fellowship Exam.  These notes have been around for a while, and are tailored to the main topics in the exam. They've been extensively revieed and updated in 2012 so they should contain some more up to date information than the previous edition.  As usual, exercise a bit of caution when using someone else's notes, check the facts yourself, but as a starting point, or as quick summaries these are a great source of information.

The next episode in the podcast is my second interview from ACEM2012 in Hobart, with Dr Alex Markwell (@almarkwell). Al is a FACEM from Brisbane who was quite strategic in her planning and execution for the exam, and provides some very practical pearls in this interview. Her great statement that "it's a marathon, not a sprint" is spot on, and highlights the need to build up your stamina over time to ensure you develop maximal exam fitness.

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A quick note for people sitting the 2013.2 (August 2013) ACEM Fellowship Exam. There is a practice written exam, organised by Southern Health in Melbourne, on June 19th (at ACEM Headquarters in Melbourne), with a feedback session on July 3rd at Monash Medical Centre in Clayton.  I must stress that this practice exam should ONLY be attended by people who have committed and are actually sitting the August exam. It is NOT appropriate for people who are usnure if they will sit, those planning to just "have a go", or those sitting in 2014.  I did this session prior to my Fellowship exam and found it a very useful guidepost for my final preparation.

You can download the flyer here, places are strictly limited,and applications close on May 17th, so get in quick!

I just returned from the SMACC Confernence in Sydney, and will post some updates in the coming weeks about content I think is relevant to EDExam readers.  One of the over-arching themes of the conference is the concept of Free Open Access Medical Education (FOAMed), as pioneered by LifeInTheFastLane founder Mike Cadogan.  Doug Lynch from Cairns was lucky enough to score a quick interview with Mike about the concept of FOAMed, and the future of this phenomenon, which you can hear below. More to follow...

This week the most ground breaking, game-changing, modern, international medical conference ever is happening.  The SMACC (Social Media and Critical Care) Conference will be held in Sydney from March 11th-13th.  With such ED and Critical Care Luminaries as:

Scott Weingart  (EMCrit)

Minh Le Cong (PHARM)

Cliff Reid (Resus.me)

The Life In The Fast Lane Crew

Simon Carely (BestBets)

Joe Lex (Free Emergency Talks & EMRAP)

The Intensive Care Network Gang

...and many more, as well as live Twitter streaming, SimWars, SonoWars and live streaming of many of the conference sessions (for people who can't attend, for free!), and an excellent interactive conference app (available here, on multiple platforms), this promises to provide a new level of conference experience, both for attendees, as well as those watching from outside.

Now for those of you who balk at the mention of "social media", or are skeptical about the use of it for medical education, I encourage you to get on board the Web 2.0 Rollercoaster, and at least register a Twitter account, start following @smacc2013 and #smacc2013, (if you want help doing this, let me know, if you get a new account, be sure to follow me as well, @edexam!), and watch the most cutting edge discussion of Critcal Care medicine ever seen happen, right in front of your eyes. I'll be there in person, and will be happy to answer any of your questions about the conference or how to follow it.  So climb on, and take the SMACC ride!

Well the cat is pretty much out of the bag, (thanks to Minh over at the PHARM Podcast) the reason my posts on EDExam have slowed down a bit is because I've been spending nearly all of my spare time in the last 9 months working on a new project. Utilising the results from our Trauma Education Needs Survey, (thanks to all who participated), Amit Maini (from www.edtcc.com) and I have created a new Emergency focused trauma course, called the Emergency Trauma Management Course (ETM Course). 

The course manual is nearly complete, we're about to start recruiting our first batch of instructors, and the aim is to launch the course in late 2013.

The logisitcs involved in getting a new course like this off the ground are immense, so we still have a lot of work to do, but if you are at all interested in the Emergency Department management of trauma, I'd encourage you to head over to our website, register your interest on our contact page, (we won't spam you, I promise), and check out the course description.  With contributions from a range of local and international Emergency Medicine and Trauma experts, based on modern educational concepts, the course features include:

• Interactive course manual available in iBook format and onilne via moodle
• Web 2.0 features including: blog, videos and podcast
• Minimal lectures on course days
• Strong focus on scenarios, small group teaching sessions and skills workshops

All delivered by Emergency Medicine experts, for anyone who manages trauma in the ED.

We have also created a new blog related to this, Resus Room Management, (RRM) where we are fleshing out the human factors and non-technical skills involved in delivering optimal resuscitation care in the ED. RRM will be taught as part of the ETM Course.

So stay tuned, more updates will follow as the course launch nears, and I look forward to bringing you a world leading trauma course, designed by Emergency Physicans, for modern Emergency Medicine practitioners.

Just a quick reminder that some of the recommended Fellowship Exam textbooks have become available on Amazon's Kindle.  Previously books like Tintinalli, Rosen, Cameron and the Roberts Procedures book were giant tomes, chained to bookshelves in ED's, or propping up people's desks at home (mine made excellent door-stops).  Well now you can carry all of these books around in your pocket!  That's right, either using your iPhone or iPad with the Kindle app, or an actual Kindle (or really lash out with a Kindle Fire) reader, you can have a mountain of exam-relevant information in your pocket.

Here's some of the great books you could only previously read at a desk:

Tintinalli's Emergency Medicine: A Comprehensive Study Guide, Seventh Edition

Clinical Procedures in Emergency Medicine (Roberts)

Textbook of Adult Emergency Medicine (Cameron)


Textbook of Paediatric Emergency Medicine (Cameron)

Now you can access all of these great books at work, on the train, at home, and even - if you suffer from insomnia - in bed, (a previously impossible task due to their sheer weight!).

Came across this great video today, of a talk by a young psychology student called Vik Nithy, via the TEDxYouth program.  I highly recommend anyone studying for their Fellowship exam, or their Primary exam for that matter, watches this talk.  You have to forgive his somewhat nervous demeanour (and he has a couple of technical hitches), but the content is so relevant to study for specialty exams, I can't emphasise it enough - if you are prone to procrastination, and it's affecting your study, this talk will show you why, and how you can learn to overcome it.

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A quick note to say good luck to everyone attempting the written ACEM Fellowship exams this week.  Remember to try and get some sleep, there's no point staying up late to cram now, you're better off showing up rested and focused.

All the best, and we'll see you on the other side!

2013 is upon us, the next written exam is a couple of weeks away, and we passed 1000 members at ED Exam a little while back now, and there are still people joining every week, which I'm really thankful for. 

2012 was a really interesting year for me, with new insights into the exam process, the many and complex changes to the training program mooted by ACEM, and I was able to make many new contacts in the online medical webucation scene.  FOAMed (check out the twitter feed #FOAMed) was born, and Mike Cadogen launched the Global Medical Education Project (GMEP), a free online portal to all sorts of insanely good medical education resources, many of which will be of use to ACEM trainees.  LITFL solidified its position as the premiere Emergency Medicine online education resource, but at last tally there were over 180 Emergency Medicine/Critical Care specific websites filling up the blogosphere. 

This leaves EDExam in an interesting position.  The niche for content on this site, and the numbers of people who access this site are really very small on the grand scale of blogging.  However, from meeting people from all around Australia and getting first hand feedback, many have found it quite useful for their Fellowship Exam preparation.  I personally feel that this utility is somewhat limited, given the clear demand for more clinically oriented sites.  This combined with the fluid status of the Fellowship Exam process and training program means I'm not sure that my efforts are best spent maintaining this site to the degree I have in the past. 

So what are you saying Andy?  Is this the end of EDExam?

Answer: Absolutely Not.

I will continue to post any exam-relevant content, including but not limited to:

• Updates to the exam process and training program made by ACEM
• The EDExam Podcast
• Study technique and memorisation articles
• Links to other sites with exam-relevant content.

However I will be focusing my energy for now on a couple of new projects, which I will write more about in the near future, and which will be of serious interest to EDExam members.

So stay tuned for more updates at EDExam, and the unveiling of my new projects.  Trust me, you'll be more interested in them than the Fellowship Exam!

Here's a snippet from the December 2012 release of the new 2013 AHA STEMI Management Guidelines, which has a couple of subtle changes to the diagnostic ECG criteria for STEMI, which may come up in the exam.  You can access the full guideline here:

"STEMI is a clinical syndrome defined by characteristic symptoms of myocardial ischemia in association with persistent electrocardiographic (ECG) ST elevation and subsequent release of biomarkers of myocardial necrosis. Diagnostic ST elevation in the absence of left ventricular (LV) hypertrophy or left bundle-branch block (LBBB) is defined by the European Society of Cardiology/ACCF/AHA/World Heart Federation Task Force for the Universal Definition of Myocardial Infarction as new ST elevation at the J point in at least 2 contiguous leads of ≥2 mm (0.2 mV) in men or ≥1.5 mm (0.15 mV) in women in leads V₂–V₃ and/or of ≥1 mm (0.1 mV) in other contiguous chest leads or the limb leads (7). The majority of patients will evolve ECG evidence of Q-wave infarction. New or presumably new LBBB has been considered a STEMI equivalent. Most cases of LBBB at time of presentation, however, are “not known to be old” because of prior electrocardiogram (ECG) is not available for comparison. New or presumably new LBBB at presentation occurs infrequently, may interfere with ST-elevation analysis, and should not be considered diagnostic of acute myocardial infarction (MI) in isolation (8). Criteria for ECG diagnosis of acute STEMI in the setting of LBBB have been proposed (see Online Data Supplement 1). Baseline ECG abnormalities other than LBBB (e.g., paced rhythm, LV hypertrophy, Brugada syndrome) may obscure interpretation. In addition, ST depression in ≥2 precordial leads (V₁–V₄) may indicate transmural posterior injury; multilead ST depression with coexistent ST elevation in lead aVR has been described in patients with left main or proximal left anterior descending artery occlusion (9). Rarely, hyperacute T-wave changes may be observed in the very early phase of STEMI, before the development of ST elevation. Transthoracic echocardiography may provide evidence of focal wall motion abnormalities and facilitate triage in patients with ECG findings that are difficult to interpret. If doubt persists, immediate referral for invasive angiography may be necessary to guide therapy in the appropriate clinical context ((10),11). Cardiac troponin is the preferred biomarker for diagnosis of MI".

 

Sorry about the hiatus between episodes. Between selling houses, extended locum stints interstate and developing a new project (which will be announced soon), the podcast took a bit of a back seat.  I was also waiting to hear about the changes to the ACEM curriculum to see if advice from people who had sat in previous years was still going to be relevant.  As you can see from my recent posts, the CRP will bring many new changes, however I still think there is a wealth of information to be gleaned from people who have sat the exam in recent years.

I was lucky enough to be able to interview a few people down at ACEM2012 in Hobart, so it's with pleasure and much gratitude that I present the first interview with Peter Jordan.  Pete is a DEMT, and was unfortunate enough to not make it through his first attempt at the exam, and he has some real pearls of wisdom for anyone sitting the exam, as well as those who have not been successful at a recent attempt, so I hope you find it useful.  More interviews from ACEM2012 to come soon...

{audio}Episode_4_Peter_Jordan.mp3{/audio}

A new book has been released by a group of FACEMs to help with the MCQ component of the ACEM Fellowship exam.  Emergency Medicine MCQs is a new book of MCQs specifically written to address all of the components of the core curriculum.  On average there are around 20-40 MCQ's per topic, (more for the expert level/common topics, less for the low level topics), and a lot of effort has been made to ensure answers are detailed, evidence based (from recommended texts, journals and web based resources), and contain core knowledge in an easy to understand format.

There is also apparently an an app on the way, which will have 180 random MCQ's (arranged into 3 x 60 question real exam format MCQ papers), which will be very useful as well.

Available at Amazon and Fishpond, and for those that use a kindle you can click this link: Emergency Medicine MCQs (Kindle Edition)

MCQs are hard to prepare for, so any help you can get for this notoriously difficult section the better, so check out this book and let us know what you think. And remember to log in to our members area and read my article on studying for and answering MCQ's.

I was lucky enough to get down to Hobart last week for the annual ACEM Annual Scientific Meeting.  Overall it was an excellent conference, with a great range of speakers and topics, and a fantastic social program culminating in a night at MONA.  Michelle Johnston (@Eleytherius) has written an excellent synopsis of the coference at Life In The Fast Lane, which you can read here.

Of relevance to EDExam readers however were two sessions that I attended. Firstly the session on the Curriculum Revision Project, and secondly was a presentation by Simon Craig, who presented the results of a survey of factors associated with Fellowship Exam success, which yielded some surprising results (which I'll cover in a separate post).

Curriculum Revision Project Session

Presented by CRP project leads, and attended by ACEM President Sally McCarthy, this was a packed "standing-room only" session, reflecting the keen interest of conference attendees in this important subject, and the session actually ran about 40 minutes into the lunch break, due to some passionate discussion and debate in the question time.

Apart from the already published exam format changes, other important aspects of the CRP were presented, including:

• ACEM has conducted analysis of the impact of the CRP on all affected groups, from medical students, through all ranks of junior doctors/Registrars, Consultants, DEMT's and ED Directors so as to ensure that all views are taken into consideration.
• Regarding implementation of changes: 18 months notice will be given with general information for major changes, and 9 months notice with specific/detailed information prior to implementation.
• Workplace Based Assessments are a very controversial subject.  In the question time, serious concerns were raised about WBA's, with possible negative implications including:
  • ED Consultants don't have time to manage their current clinical workload, especially in the face of the 4-hour rule, so adding new supervision/feedback duties, with specific, high-stakes assessment requirements is not feasible for those working on the floor.
  • There is overwhelming pressure to provide pass marks for all WBA's for all registrars, as the fallout from failing someone in a WBA is massive, and can include complaints, dispute resolution/mediation processes and even legal action. This "pressure to pass" is seen by many as a major downfall of WBA's.
  • A counter argument was raised that each WBA should be of lower stakes, (possibly achieved by increasing the numbers of WBA's... groan) so that failing one or two is not only acceptable, but expected, and that one or two fails won't adversely affect one's progress through training.
  • A recurrent theme was that many FACEMs aren't interested in teaching or assessment. Many just want to come to work, do their clinical shifts and go home.  From what I understood, the College's argument was that teaching and assesment are actually core skills of being a FACEM, and that it will actually be part of your future job requirements.  Personally I have grave concerns about forcing people to do things they lack interest or formal training in, and have no skills in (analagous to the 4.10 issue, and the clear fact that most people aren't interested in doing research, as evidenced by the small numbers actually doing formal research for their 4.10 since the introduction of the alternative pathways).  ACEM is providing teacher/assessor training for FACEMs, but the utility of this will be hard to quantify, and while we all know that being taught by people with no teaching skills, (how nearly everyone of the current medical generation has been taught), is bad, we won't know how good the new system will be until it's trialled.

Despite the many criticisims of the CRP, (and there were many!), one thing that stood out was the enormous amount of work and thought that's being put into this process, so while various aspects of it  may seem flawed in may people's opinions, rest assured that no change will be made without serious analysis.

As mentioned in my previous post, those planning on sitting the Fellowship exam in the next year or two need to pay close attention to the CRP changes, bookmark the ACEM website and monitor CRP updates closely, liaise frequntly with your DEMT and any ACEM Examiners you know, and make sure that everyone in your study group is up to speed with the changes.  I'll endeavour to keep you updated as well, as the new exam formats will require new study and preparation techniques.

 

Coming soon... Simon Craig's Presentation at ACEM 2012 on a survey which looked at specific factors associated with Fellowship Exam success.

CRP: Not just a useless blood test!
Many of you would now know that ACEM is redesigning the training program, which will change the way your progress through ED training is monitored and assessed.  Perhaps most notably will be changes to the Fellowship Exam structure.  In a statement released just over a week ago, (which you can access here) the College gave a clear update on the planned changes, which (apart from containing the seemingly mandatory photos of the very good looking Registrars and Consultants at Southern Health in the pdf's!) has all of the documents you should read if you are starting your ED training, or are planning on sitting the Fellowship Exam in the next 2-3 years.

Some of the proposed changes over the next few years include:

• Changes to the Primary Exam - aready implemented
• Changes to the Fellowship Exam, including:
  • Improved MCQ's: increased clinical relevance and possible replacement with other formats like EMQ's
  • Removal of VAQ and SAQ sections and replacement with other "more feasible and clinically applied forms of assessment" (not defined)
  • Long and Short cases removed and replaced with improved/expanded SCE's
  • SCE's may include elements such as:
    • Simulation
    • Standardised patients
    • Assessment of non-technical skills
  • SCE's may focus on asessment of:
    • Teaching skills
    • Health Advocacy skills
    • Critical Research Literature Appraisal & Application of EBM
• Implementation of:
  • Online learning portfolio
  • the dreaded WBA's - Workplace Based Assessments

Like any big change in any organisation, there will no doubt be hiccups, a few people who get upset and (hopefully) fewer still who are screwed over by the process.  Having said that I believe that on the whole these changes are for the better, and reflect the current extremely pro-active stance of the College.

Some of the benefits will be:

• A clearer set of standards/objectives for your training - which will force your hospitals to provide you with the required training/skill acquisition. This may sound silly, but I and many of my Consultant colleagues got through without ever doing or being taught certain procedures or skills, which is a big deficiency of the current system.
• A more standardised and therefore (theoretically) fairer exit exam
• A focus on teaching FACEMs actual teaching skills.  One of my main gripes with medical specialty training is that we are taught by people with no teaching qualifications.  ACEM is trying to rectify this, which should hopefully make your Consultants better clinical teachers.

Some of the downsides are:

• WBA's: these will create even more forms to fill out, and if i could quote an eminent British Emergency Physician who spoke at the ACEM Conference in Syndey last year about WBA's: "we just glanced at them, and as long as they weren't filled out in crayon, or didn't look like thier mum had filled them out, we just passed them".  This refers to the extreme volume of paperwork created for Consultants by implementaiton of WBA's, and the lack of scrutiny they may undergo, so hopefully ACEM will bear this in mind.
• Those caught up in the transition phase may find it hard to have clear exam study goals a year or so in advance, which is the time required to prepare for the Fellowship Exam.

Of course I'll try and keep you up to speed with the changes as they are implemented.  There will now be new exam preparation techniques, new study methods, and I predict some new exam preparation courses that you can attend, but I encourage you to sit down with your DEMT's soon and talk about your exam plans, even if it's 2-3 years away, keep a close eye on the CRP section of the ACEM website for updates, and be strategic about when you sit the exam.

The ACEM2012 Conference (being held in Hobart next week), has launched an iphone app to help you navigate your way through the conference.  It contains the conference program, map, direct Twitter links so you can tweet from the conference (be sure to use #ACEM2012 in your tweets), and a news section for real time updates on all the action.

If you're heading down to Hobart next week, check the app out, tweet me and we can meet up for a sparkling Tasmanian ale!

Just found about about a new site, Wellingtin ICU, (New Zealand), which has loads of useful ICU study resources, including a collection of 355 Mindmaps (yes, 355!) on various ICU topics, study note collections and some new links on ICU equipment. It's still growing, and not all the links have content yet, but looks like it'll be a really useful site for ED Reg's doing their ICU rotations, and for those poor study-addicted souls who can't seem to get off the study train after the ACEM Fellowship exam and keep going for the FCICM!

And it's great to finally see some action from our Crit Care colleagues across the pond!

Click here to check out Wellington ICU Education Resources.

It had to happen at some point.  So many reduction techniques, so many eponymous names, which ones work, which ones don't, what's the evidence for this technique vs that technique, my old boss showed me  this neat trick, works every time... Nitrous vs midaz vs Propfol vs accupuncture vs hypnosis, do you use a towel, a sheet or a foot in the axilla? Do you need to learn scapular manipulation or Orthopaedic Registrar manipulation?

Well now you can forget everything you've ever heard about shoulder dislocation and start from scratch. Check out shoulderdislocation.net, the best, most comprehensive, beatifully laid out site on shoulder dislocation you've ever seen. 13 videos and loads of articles on different reduction techniques, aftercare advice and more. For those just starting to learn about reducing shoulders, it will be invaluable, but there's plenty there for the experts amongst us as well.

Alright, the time is here again, another round of clinical exams coming up this weekend.  Hopefully those going to Adelaide are well prepared, rested, and ready to blitz it.  Good luck to everyone heading to SA, and we'll see you on the other side!

Thanks again to everyone who completed the EDExam/EDTCC Trauma Education Needs Survey.  In the interest of open disclosure I've filmed the selection of the prize winners - I think you'll agree that a 3 year old mid-breakfast at 6am is a pretty random selction tool, so the results are final!

We had nearly 200 responses to the survey and we will are already using the results to design an exciting new trauma education project, more details coming soon...

{m4v}Results|300|220{/m4v}

This is a review of a great book I've recently read, and whilst technically not exam-related, I think it's still worth putting on your reading list - you'll see why.

Band-Aid for A Broken Leg (And Other Ways to Stay Single) is written by Damien Browne, a South-African born, Australian raised doctor who I've had the absolute pleasure of working with up in Darwin, which is how I found out about the book.  Damien and I were both locuming in the Royal Darwin ED, and as is the tendency when you meet a fellow non-mainstream-medical person, traipsing about the country on the locum trail, you tend to ask how they ended up there.  We got chatting and Damien revelaed his amazing story of travelling to Africa to work with MSF, and his subsequent mission to do locum work in Australia which helped him to be able to take the time off to write the book.

For those who've done aid-work, the stories will probably seem familiar, but for those of us who haven't, Damien's first hand narrative from a perspective we are all familiar with (being an up and coming junior doctor in the wealthy Australian health system) makes visualising the scenes he describes frighteningly realistic. Imagine being plonked into a small village in rural Angola with the bare minimum of staff and supplies, and having to treat major trauma, undifferentiated sepsis (in a country with more exotic pathogens than you could dream of, and no lab tests!), paediatric resuscitations, obstetric disasters including a ruptured uterus which you have to perform the laparotomy on (with only ketamine as sedation, no suction and your operating light powered by a car battery), and malnutrition.  Add to this the complexity of navigating the cultural quagmire of a country recently devastated by civil war, the local hospital heirachy and learning a new language (and not an easy one like French or Spanish, Damien had to learn medical & social Portugese!), and it makes for compelling reading.

In Australian hospitals, junior doctors wouldn't be allowed near a lot of these patients, but as an aid-worker, it's you or no-one, so one gets to practice in the true sense of the word.  Flying by the seat of your pants is the norm, and I have no doubt that doctors who do this sort of work develop skills, confidence, and perspective that  most of us can only dream of. The risks of aid-work are also covered, and there are some harrowing reminders of the dangers involved, not only in the field, but also on return to "civilisation" and the difficulties some face trying to re-integrate back home.

A level-headed, non-judgemental but stark comparison is made to the extreme affulence of our health system, when he starts back at work in an Australian tertiary ICU.  Whilst making no judgements, the book serves as an unsettling reminder of how cheap life is in some places, and how totally over-valued it in wealthy countries like ours, and how much we (and the general public here) take for granted. His description of the resource-intense management required for a drunk violent patient in ED - something we deal with every other day - again highlights this divide, and the fact that a lot of what we do at work is a serious waste of our skills.

I may be biased having met Damien and hearing the background to this book first hand, but overall I found Band-Aid for A Broken Leg a "can't put down" read.  If you are feeling disillusioned with the drudgery of ED training, studying for the exam or the pressures of the public hospital system here, I'd strongly recommend you read this book, both as a reminder of just how good we've actually got it, and as an insight into a way you can actually make a powerful difference into the lives of strangers, should you choose to one day sign up and do some aid work.

For those who prefer Kindle, you can get it here.

For those who like paperback - it seems to be selling out - so try ordering it from your LBS or at the time of writing you could still get it at the ABC shop online.

(Please note - these are not affiliate links - I get no commision - I just reckon it's a great book that you should buy!)

EDExam Book Rating: 5 Stars!

Oh, and if this has piqued your interest, check out the Médecins Sans Frontières webiste...

A quick thanks to everyone who has gone to the effort to complete the Trauma Education Needs Survey that Amit Maini and I put together.  We've had nearly 200 responses, and the survey is closing this Friday,  September 28th, so if you haven't done it, get in quick, and you'll go into the draw to win one of five $50 gift vouchers.

Click here to take the survey

The response so far has been fantastic, and your input will help shape the future of Emergency trauma education, so have your say today!

Based on my efforts with this site and my editorial in EMA earlier this year on medical journals and Web 2.0, I was very privileged to be invited to the Emergency Medicine Australasia strategic planning day at ACEM headquarters in Melbourne, held yesterday.  Present were several esteemed members of the Editorial team, the ACEM CEO Alana Killen, Dr Andrew Gosbell (director of policy and research at ACEM), several members of the EMA section of Wiley Blackwell, as well as myself and Dr Mike Cadogan of LifeInTheFastLane fame.  Mike and I were invited to provide perspective on the booming free online Emergency Medical Education scene, and how this can tie in with the future of EMA.

Rather than go into the details of what was discussed, I'd like to summarise some of the overall themes of the meeting. Based on recent surveys of Editors, authors and readers, there was a strong push from the EMA Editors to increase the quality of research in the journal, a broader international perspective and "more clinical relevance" of the content were also big themes.  More educational content and trainee input were also discussed at length. Of course, online access was a hot topic. Several options for improvement in online access were tabled, as well as a lengthy discussion about the utility of social media in this process. 

The elephant in the room was (and still is) free open access to journal content.  Without going into too much detail, this is a conundrum being faced by all in the scientific community at the moment.  The inescapable fact is: research costs money, publishing and distribution (even online) costs money.  I don't want to start a debate about this, as I know people have strong opinions about it, but let me assure you that the Editors of EMA are thinking very progressively in the area, and are strongly in favour of free, open online access.  How this pans out in the real world is anyone's guess, but the fact that it was able to be discussed at length with the publishers shows that at least they are open to discussion about it.

Believe it or not, EMA is struggling to find section editors.  There are at least 4 or 5 sections without editors at present, which places a huge burden on those who volunteer to edit or review for the journal.  For those with any interest in getting involved, watch for expressions of interest offers coming from ACEM/EMA, and I'd strongly encourage anyone with an interest in research to get involved.  Having never met the editorial members before, I found them to be very positive, highly motivated, altruistic individuals with very high academic standards. 

Interestingly, for those of you who hate getting the print version of the journal, the option to receive it only in digitial format is coming. I was surprised to hear that ACEM went "digital only" with Your Directions (the College newsletter for FACEMs), only to face a barrage of complaints - to the point where they have to start sending print copies again! A lot of people still want paper.  Amazingly it seems that despite a lot of the currently available media technology, and the obvious environemental issues, medical people are still very slow to get onboard with paperless communication, which is frustrating for the early adopters, but is in fact the reality we are dealing with.

I was fortunate enough to be able to speak to some of the team from Wiley, and they reiterated to me that compared to some of the other Australian medical specialty colleges they deal with, ACEM is seen as very progressive, positive and forward thinking organisation.  So for those who have any animosity toward the College, or feel at times disgruntled with or distanced from EMA, the openness to change, and willingness to get on board with things like social media and free open access content shows a degree of modernity lacking in many other specialties and their journals.  Most of the issues people have with the journal are known about, and there are many behind the scenes issues that restrict change, many related to the relatively small size of our specialty membership, and small population, and therefore our research base. 

Wheels turn slowly in big organisations, so progress may be slow, but it is happening, and before you have your next whinge about EMA, drop me a line, or tweet Andrew Gosbell at @acemonline, get engaged and find out what's happening, because it's likely they know what your whingeing about already and have already developed a strategy to fix it!

I hope this clarifies some of the mystique around EMA and medical journal publsihing in general.  The team at EMA are aware of the sense many of us have that it is an exclusive club that only the "usual suspects" are involved in, and are working hard to dispel this myth, thanks largely to Editor in Chief, Tony Brown, and Andrew Gosbell who are putting a huge amount of energy, time, work and enhtusiasm into making EMA a progressive, modern, high-quality journal that strives to meet the needs of its readers. 

We'll wait to see what comes from the meeting yesterday, but an over-arching theme was to try and bring the standard of EMA into alignment with the very high clinical reputation of Australian (and NZ) Emergency Physicians and educators.  If you are a trainee or FACEM, and are in any way interested in getting invoved in EMA, they'd be more than happy to hear from you.

Me (Andy Buck), Mike Cadogan, George Jelenik, Tony Brown and Andrew Gosbell - group hug after the EMA Strategic Planning Day. 

By the crew over at Westmead in Sydney comes the appropriately named EDjunction site.  It is essentially a links resource to all of the best online EM education content, with a strong focus on the ACEM Fellowship exam (thanks for the link guys!) and Australian based sites.  Brand new, and sure to evolve into something really useful, check it out if you're starting your ACEM Fellowship Exam preparation.