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SPECIAL CONTRIBUTION

Clerkship Directors in Emergency Medicine:


Statement of Purpose
David A. Wald, DO, David E. Manthey, MD, Michelle Lin, MD, Douglas S. Ander, MD, Jonathan
Fisher, MD

Abstract
The Academy of Clerkship Directors in Emergency Medicine (CDEM) provides a forum for the collabo-
rative exchange of ideas among emergency medicine (EM) medical student educators, a platform for the
advancement of education, research, and faculty development, and establishes for the first time a
national voice for undergraduate medical education within our specialty. CDEM plans to take a leading
role in providing medical student educators with additional educational resources and opportunities for
faculty development and networking. CDEM will work to foster the professional growth and develop-
ment of undergraduate medical educators within our specialty. The advancement of undergraduate edu-
cation within our specialty and beyond will come primarily from the support, hard work, and dedication
of the educators. To accomplish our goals, at the departmental, medical school, and national level, we
must come together to further promote our specialty across the spectrum of undergraduate medical
education. The first step has already been taken with the formation of the Academy of CDEM.
ACADEMIC EMERGENCY MEDICINE 2008; 15:856–859 ª 2008 by the Society for Academic Emergency
Medicine

T
he Academy of Clerkship Directors in Emergency (http://www.saem.org/saemdnn/), in the September ⁄
Medicine (CDEM), formed in 2008, provides a October issue of the SAEM Newsletter President’s mes-
forum for the collaborative exchange of ideas sage, and on the CDEM website (http://www.saem.org/
among emergency medicine (EM) medical student edu- CDEM).
cators and a platform for the advancement of education, The idea of CDEM in its present form was conceived
research, and faculty development and establishes for during an informal meeting of medical student educa-
the first time a national voice for undergraduate medical tors in New Orleans in October 2006. Following the
education within our specialty. CDEM is the first ‘‘Acad- meeting, a needs assessment survey was developed and
emy’’ within the Society for Academic Emergency Medi- distributed to EM clerkship directors and medical stu-
cine (SAEM) membership and views its mission as being dent educators across the country. From these targeted
aligned with other national organizations that have set surveys, a number of equally important broad areas of
forth to promote and champion the cause of undergrad- need were identified. Medical student educators in our
uate medical education in their respective specialties.1–7 specialty have reported the need for additional oppor-
Our mission statement is presented in Table 1. Member- tunities faculty development, networking, fostering
ship in CDEM is open to all categories of SAEM mem- educational research, the development of educational
bers. More information on the development of the resources, and a unified voice at the national level.
Academy structure can be found on the SAEM website Even in its infancy, CDEM has started to address
some of these areas of need by working with the Coun-
From the Department of Emergency Medicine, Temple Univer- cil of Emergency Medicine Residency Directors (CORD-
sity School of Medicine (DAW), Philadelphia, PA; the Depart- EM) to develop a medical student educator track at the
ment of Emergency Medicine, Wake Forest University School 2007 and 2008 CORD-EM Academic Assembly. CDEM
of Medicine (DEM), Winston-Salem, NC; the Department of will continue to develop educational sessions for future
Emergency Medicine, UCSF-San Francisco General Hospital CORD meetings, and will be submitting didactic pro-
(ML), San Francisco, CA; the Department of Emergency Medi- posals for future SAEM annual meetings. To further
cine, Emory University School of Medicine (DSA), Atlanta, GA; enhance the EM clerkship experience, CDEM members
and the Department of Emergency Medicine, Beth Israel are working on a resource for clerkship directors and
Deaconess Medical Center (JF), Boston, MA. medical students entitled ‘‘The Emergency Medicine
Received April 25, 2008; accepted June 13, 2008. Clerkship Primer: A Manual for Medical Students.’’ This
Address for correspondence and reprints: David A. Wald, DO; manual will focus on the needs of medial students as
e-mail: waldda@tuhs.temple.edu. they prepare for their EM clerkship. Similar manuals

ISSN 1069-6563 ª 2008 by the Society for Academic Emergency Medicine


856 PII ISSN 1069-6563583 doi: 10.1111/j.1553-2712.2008.00207.x
ACAD EMERG MED • September 2008, Vol. 15, No. 9 • www.aemj.org 857

Table 1 school of medicine. Fostering, promoting, and support-


Clerkship Directors in Emergency Medicine (CDEM) ing the role of the clerkship director at the departmen-
tal and medical school level is paramount for a
Mission Statement: successful career and enhanced job satisfaction for fac-
The Academy of CDEM is composed of emergency medicine ulty who view undergraduate medical education as a
clerkship directors and medical student educators who are career, not merely a stepping stone.10–12 Recently, a
committed to enhancing medical student education in emer- multidisciplinary group of medical student educators
gency medicine.
Our Mission Is: published recommendations for the resources and sup-
1. To advance the education of medical students as it per- port necessary for clerkship directors to be successful
tains to the specialty of emergency medicine and acute care as academic faculty.13 This collaborative statement from
medicine. the Alliance for Clinical Education estimates that the
2. To serve as a unified voice for emergency medicine clerk- time allocation required for a clerkship director to per-
ship directors and medical student educators.
3. To provide a forum for emergency medicine clerkship form clerkship administration and other related educa-
directors and medical student educators to communicate, tional activities is equivalent to 25%–50% of a full-time
share ideas, and generate solutions to common problems. equivalent. Although an EM representative was not
4. To foster undergraduate medical education research. part of this collaborative effort, the recommended
5. To foster the professional development and career satis-
faction of emergency medicine clerkship directors and medi-
guidelines could be applicable to EM clerkship directors
cal student educators. of mandatory or high-volume clinical rotations. Similar
6. To foster relationships with other organizations that pro- statements outlining the expectations of clerkship direc-
mote medical education. tors have been developed by medical student educators
in internal medicine and psychiatry.14,15 A document
outlining the expectations of the EM clerkship director
does not yet exist. Partly because of this, the relative
have been developed by medical student educators in infancy of our specialty, and the prior lack of a unified
internal medicine and obstetrics and gynecology.8,9 For voice at the national level, the role of the EM clerkship
both medical students and medical student educators, director has not been traditionally looked at in the same
CDEM has developed a website that will house a host light as clerkship directors in other fields of medicine.
of educational material under one umbrella. In addition, On average, EM clerkship directors are between 5
in the upcoming year, members of CDEM will be revis- and 10 years younger, more likely to be junior faculty
ing the Medical Student Educators Handbook. at the clinical instructor or assistant professor rank,
For decades, EM medical student educators have and more likely receive less protected time for clerkship
greatly impacted the educational experiences of medical administration than our counterparts in other special-
students. These educators comprise medical school and ties.16–22 In addition, clerkship directors in other fields
residency faculty, EM physicians who practice in aca- of medicine have on average held their present position
demic affiliate training sites, and others who practice in for 5–8 years. This is in stark contrast to our specialty,
the community hospital setting. Presently, there are where it was reported in 2005 that 45% of EM clerkship
more than 170 allopathic and osteopathic medical directors were in their present position for only
schools. As of 2008, there are 143 allopathic and 1–2 years and fewer than 25% have held their position
37 osteopathic EM residency training programs in the longer than 5 years.16 In this study, EM clerkship direc-
United States and, among them, many hundreds of EM tors also report receiving on average only 2.7 hours per
medical student educators. Across the country, these week of a clinical load reduction, and 51% reported that
educators are involved in many aspects of undergradu- they had no clinical hours set aside to perform clerk-
ate medical education including: clinical, procedural, ship administrative duties. It is unclear as to why there
and simulation skills training; curriculum development; is such a turnover in this position, although the lack of
clinical clerkship; and medical school administration, protected time for clerkship administration and other
along with their role in advising and mentoring medical scholarly pursuits may play a role. Further research is
students applying to EM residency training programs. necessary to identify issues related to job satisfaction
The CDEM plans to take a leading role in providing and career longevity among this academic group.
these educators with additional educational resources Medical student educators have also stated that the
and opportunities for faculty development and net- roles of the clerkship director and residency program
working. CDEM will work to foster the professional director are and should be viewed as comparably valu-
growth and development of undergraduate medical able positions.13 With this in mind, clerkship directors of
educators within our specialty. By doing so, our career mandatory and high-volume EM rotations deserve
satisfaction and longevity will undoubtedly be equivalent protected time from clinical duties to allow
enhanced. In the initial development stages, CDEM, will for clerkship administration, medical student teaching,
focus on: 1) further supporting EM clerkship directors and participation in other scholarly pursuits, such as
and therefore reducing the rapid turnover, 2) enhanc- educational research. However, at the present time in
ing the quantity and quality of EM education in medical our specialty, this is not necessarily the case. EM clerk-
schools across the country, and 3) fostering collabora- ship directors are younger, more likely to be junior fac-
tion with organizations both within and outside of EM ulty, and more likely receive significantly less protected
that support undergraduate medical education. time when compared to EM residency program direc-
Clerkship directors across all specialties play a vital tors.16,23 Medical student educators should be embraced
role both in the academic department and within the within an academic department and our specialty, similar
858 Wald et al. • CLERKSHIP DIRECTORS IN EM: STATEMENT OF PURPOSE

to residency program directors, whose job qualification cussions with the Alliance for Clinical Education
and description is delineated in the Accreditation Coun- regarding future collaboration.
cil for Graduate Medical Education (ACGME) program In summary, the advancement of undergraduate edu-
requirements for graduate medical education in EM.24 cation within our specialty and beyond will come primar-
Furthermore, based on a recently published SAEM fac- ily from the support, hard work, and dedication of the
ulty salary survey, residency program directors work on educators. To accomplish our goals at the departmental,
average 16.7 clinical hours per week.25 medical school, and national level, we must come
A second focus for CDEM revolves around enhanc- together to further promote our specialty across the
ing EM undergraduate education in all U.S. medical spectrum of undergraduate medical education. The first
schools. For many years, medical student educators step has already been taken with the formation of the
have called for an increased emphasis on EM in the Academy of CDEM. We welcome your input to shape
undergraduate curriculum.26–31 However, as of 2005, this organization from those who support its mission.
only one-third of medical schools have incorporated a
mandatory EM clerkship into the clinical years.28,32 An References
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