I think I can safely comment on the College attitude to these things -
in New Zealand anyway.
The Australasian College regards the FACEM (an exit exam) as the desired
qualification of an Emergency Physician 
The EMST(Australasian ATLS) APLS and ALS qualifications are all very
well and laudable things to possess and even better to instruct. However
a "FACEM" is regarded as possessing both knowledge and experience in
these areas of practice significantly in excess of these certificates -
which can after all be gained in just a few days and do not
imply/require real clinical acumen or experience. In particular the
possession of an EMST certificate is not mandatory for training as this
is licensed by the College of Surgeons and one College should not be
"beholding" to another for an essential part of training.
For an employer to specify APLS or ATLS as additional requirements for a
specialist appointment demonstrates a lack of understanding of what it
takes to become an Emergency Specialist ...but I am sure they seem sort
of "good things" to put in the ad. by whoever makes it up ...and I
suppose that is quite often senior Emergency specialists ?!!?

John Chambers
(Faculty Board member New Zealand, EMST instructor ,APLS instructor etc
etc)


-----Original Message-----
From: Cliff Reid [mailto:[log in to unmask]]
Sent: Tuesday, 27 November 2001 8:26 p.m.
To: [log in to unmask]
Subject: Merit Badging - who 'sucks' as an Emergency Physician?


(Forgive me if this has been discussed before - I can't remember)

An interesting post was put on the (mainly american) pediatric (sic)
emergency medicine mailing list which I've pasted below, concerning the
inappropriateness of demanding that a qualified emergency physician be
currently certified in PALS.
I feel that if 5 years of registrar training do not equip someone with
the
skills and knowledge required of an ALS provider, we're doing something
seriously wrong, and I would even extend that to cover ATLS and APLS.
So should the Faculty take a similar stance to the American College
against
such 'merit badging'. It's perhaps fair enough to expect interested SHOs
to
have these courses behind them before embarking in higher specialist
emergency medicine training, but should they then be expected to
re-certify
or re-do courses at considerable expense (unless of course they want to
be
instructors), when there are plenty of other good courses to spend a
limited
study leave budget on? I realise for those of us who are instructors
it's
less relevant, but nevertheless I can't help feeling my training is
being
undermined when A&E consultant job ads require both a CCST in emergency
medicine and 'current ALS & ATLS certification'.
Anyone know the Australasian College's position on this, particularly as
APLS is pretty hard to get onto for the folks over here?

Cheers

Cliff Reid
Australia

(I wonder if Adrian's still up!)


as you know, the American College of Emergency Physicians has taken a
stand
against merit badging in emergency medicine.  Meaning that if a
physician
is board certified in emergency medicine, he or she should not be
required
by a hospital to also have a current PALS, BLS, ACLS, or ATLS
card.  Obviously if an emergency medicine physician only knows what is
taught in PALS for example, then he or she sucks as an emergency
physician.

For years our program has been giving our new EM residents a PALS course
when they start their residency which does have some basic peds
resuscitation info that is good.  Recently we altered the course to be
more
a Pediatric Critical Care day.  They receive skills stations and
lectures
including additional ones on pediatric seizures and more in-depth
respiratory cases.  We've used the slides from the AAP/ACEP  APLS course
which are much better than the PALS slides.  For those of us who would
rather die than teach another PALS class, this beefed up course was a
nice
change.

What are residencies doing about graduating residents who are asking to
be
re-certified in PALS because "their cards expired".  Their new jobs are
asking for current PALS cards.  If we "recertify" them, and give them
cards, this just perpetuates the hospitals to ask again for current
cards.  When is the cycle going to stop?  How do we stop the madness?



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