EMCC consist of four components.
These are:

• Professional Standing.
• Lifelong Learning and Self-Assessment (LLSA).
• Assessment of Cognitive Expertise.
• Assessment of Practice Performance.

What's new

Professional Standing.
Beginning in 2004, diplomates must hold at least one medical license in the United States, its territories, or Canada, that is active, current, valid, unrestricted, and unqualified throughout the time that they are certified. ABEM will verify all diplomate's medical licenses at the time they register for the ConCert examination, and ABEM will randomly verify the licenses of 5% of its diplomates annually.

Life Long Learning Self assessment (LLSA).
ABEM will publish 20 readings each year in December. The reading lists for 2004, 2005 and 2006 are available. A 40 question test will be prepared based on these 20 articles. The tests will be posted and can be taken on the ABEM web site. The first test will be available after April 5th, 2004. Each test will remain on the ABEM site for 3 years. Diplomates will have 3 tries to pass the each exam. Most readings can be found directly from the link on the ABEM website. Two commercial product is available. This is not an endorsement of either.
http://www.emprep.org/emprep/index.html
http://www.emedhome.com/cme_about-concert.cfm

Assessment of Cognitive Expertise (ConCert).
The examination will be administered in a computer lab at about 200 locations. The exam will take place the first week in November 2004. The exam will be a one half day session. Some of the questions on the exam will be based on the LLSA readings. The amount of questions from the LLSA reading will increase over the years to about 40%.

Assessment of Practice Performance.
Yet to be developed and implemented.

For details go to http://www.abem.org/diplomates/.

1. Professional Standing
   • Diplomates must hold at least one medical license in the U.S., its territories or Canada that is active, current, valid, unqualified, and unrestricted throughout the time that they are certified.
   • All licenses held must meet ABEM criteria.
   • Diplomates may hold voluntarily inactive licenses.
   • Diplomates will attest that their licenses meet the criteria stated above each time they take the LLSA tests.
   • ABEM will randomly verify the licenses of 5% of its diplomates annually.
   • ABEM will verify licenses each time diplomates register for the ConCert examination.
2. Lifelong Learning and Self-Assessment (LLSA)
• A list of 20 readings based on the EM Model will be posted on the ABEM website each year.
• 40-item LLSA tests will be developed based on the annual readings.
• A new LLSA test will be posted on the ABEM website each year.
• Each LLSA test will remain online for three years.
• Once registered for an LLSA test, diplomates will have three opportunities to pass per registration.
3. Assessment of Cognitive Expertise
• The Continuous Certification (ConCert) examination will be a comprehensive examination based on the LLSA readings and the EM Model.
• ConCert will typically occur in the tenth year of each diplomate's EMCC cycle.
• ConCert will be a half-day examination.
• ConCert will be administered at computer-based testing centers around the country.
4. Assessment of Practice Performance
   • Activities will be focused on practice improvement.
   • Activities will offer diplomates a choice of ways to meet requirements.
   • Activities will not require that diplomates be clinically active in EM, but will also be available to other diplomates like those engaged in EM teaching, research, or administration.
   • The Board is currently discussing specific options that will be developed over the next several years.

Content Area 9. Immune System Disorders

Cines DB, Blanchette VS. Immune thrombocytopenic purpura. N Engl J Med. March 2002;346:995-1008.

Schriger DL, Mikulich VJ. The management of occupational exposures to blood and body fluids: revised guidelines and new methods of implementation. Ann Emerg Med. March 2002;39:319-328.

Content Area 11. Musculoskeletal Disorders (Non-traumatic)

Deyo RA, Weinstein JN. Low back pain. N Engl J Med. February 2001;344:363-370.

Perron AD, Miller MD, Brady WJ. Orthopedic pitfalls in the ED: pediatric growth plate injuries. Am J Emerg Med. January 2002;20:50-54.

Content Area 16. Thoracic-Respiratory Disorders

Gibbs MA, Camargo Jr CA, Rowe BH, et al. State of the art: therapeutic controversies in severe acute asthma. Acad Emerg Med. July 2000;7:800-815.

Small PM, Fujiwara PI. Management of tuberculosis in the United States. N Engl J Med. July 2001; 345:189-200.

Kline JA, Johns KL, Colucciello SA, et al. New diagnostic tests for pulmonary embolism. Ann Emerg Med. February 2000;35:168-180.

American College of Emergency Physicians. Clinical policy for the management and risk stratification of community-acquired pneumonia in adults in the Emergency Department. Ann Emerg Med. July 2001;38:107-113.

Orebaugh SL. Difficult airway management in the Emergency Department. J Emerg Med. January 2002;22:31-48.

Vichinsky EP, Neumayr LD, Earles AN, et al. Causes and outcomes of the acute chest syndrome in sickle cell disease. N Engl J Med. June 2000;342:1855-1865.

Selections from the Remainder of the Listing of Conditions and Components

The Model of the Clinical Practice of Emergency Medicine

Content Area 3. Cardiovascular Disorders

Weber JM, Chudnofsky CR, Boczar M, et al. Cocaine-associated chest pain: how common is myocardial infarction? Acad Emerg Med. August 2000;7:873-877.

Content Area 5. Endocrine, Metabolic & Nutritional Disorders

Harrigan RA, Nathan MS, Beattie P. Oral agents for the treatment of type 2 diabetes mellitus: pharmacology, toxicity, and treatment. Ann Emerg Med. July 2001;38:68-78.

Content Area 6. Environmental Disorders

Bouchama A, Knochel JP. Heat stroke. N Engl J Med. June 2002;346:1978-1988.

Hackett PH, Roach RC. High-altitude illness. N Engl J Med. July 2001;345:107-114.

Content Area 10. Systemic Infectious Disorders

Ryan ET, Wilson ME, Kain KC. Illness after international travel. N Engl J Med. August 2002;347:505-516.

Content Area 17. Toxicologic Disorders

Bond GR. The role of activated charcoal and gastric emptying in gastrointestinal decontamination: a state-of-the-art review. Ann Emerg Med. March 2002;39:273-286.

Mettler FA Jr, Voelz GL. Major radiation exposure - what to expect and how to respond. N Engl J Med. May 2002;346:1554-1561.

Content Area 18. Traumatic Disorders

Hoffman JR, Mower WR, Wolfson AB, et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med. July 2000;343:94-99.

Solomon DH, Simel DL, Bates DW, et al. Does this patient have a torn meniscus or ligament of the knee? JAMA. October 2001;286:1610-1620.

Content Area 20. Other Components

Schenkel S. Promoting patient safety and preventing medical error in emergency departments. Acad Emerg Med. November 2000;7:1204-1222.

2005 Reading List

deGans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Eng J Med. Nov 2002;347:1549-1556.

Hasbun R, Abrahams J, Jekel J, et al. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. Dec 2001;345:1727-1733.

Lewandowski C, Barsan W. Treatment of acute ischemic stroke. Ann Emerg Med. Feb 2001;37:202-216.

Schutzman SA, Greenes DS. Pediatric minor head trauma. Ann of Emerg Med. Jan 2001; 37:65-74.

Warden CR, Zibulewsky J, Mace S, et al. Evaluation and management of febrile seizures in the out-of-hospital and emergency department settings. Ann Emerg Med. Feb 2003;41:215-222.

Blackburn P, Vissers R. Pharmacology of emergency department pain management and conscious sedation. Emerg Med Clin N Am. Nov 2000;18:803-826. (Note: The content of this reading also relates to Content Area 19, Procedures and Skills.)

Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of methanol poisoning. N Engl J Med. Feb 2001;344:424-429.

Kosten TR, O'Connor PG. Management of drug and alcohol withdrawal. N Engl J Med. May 2003;348:1786-1794.

Mason PE, Kerns WP II. Gamma hydroxybutyric acid (GHB) intoxication. Acad Emerg Med. July 2002;9:730-739.

Shannon M. Ingestion of toxic substances by children. N Engl J Med. Jan 2000;342:186-191.

Goldman B. Vertigo and dizziness. Tintinalli JE, et al (eds): Emergency Medicine, A Comprehensive Study Guide, ed 5, 2000, pp 1452-1463.

Kapoor WN. Syncope. N Engl J Med. Dec 2000;343:1856-1862.

Andersen HR, Nielsen TT, Rasmussen K, et al. A comparison of coronary angioplasty with fibrinolytic therapy in acute myocardial infarction. N Engl J Med. August 2003;349:733-742.

Young JB, Publication Committee for the VMAC Investigators. Intravenous nesiritide vs nitroglycerin for treatment of decompensated congestive heart failure: a randomized controlled trial. JAMA. March 2002;287:1531-1540.

Zimetbaum PJ, Josephson ME. Use of the electrocardiogram in acute myocardial infarction. N Engl J Med. March 2003;348:933-940.

Petersen LR, Marfin AA, Gubler DJ. West Nile virus. JAMA. July 2003;290:524-528.

McIntosh K. Community-acquired pneumonia in children. N Engl J Med. Feb 2002;346:429-436.

Bulloch B, Neto G, Plint A, et al. Validation of the Ottawa knee rule in children: a multicenter study. Ann Emerg Med. July 2003;42:48-55.

Hollander JE, Singer AJ. Laceration management. Ann Emerg Med. Sept 1999;34:356-367.

Melanson SW, Heller MB. Principles of emergency department sonography. Tintinalli JE,et al (eds): Emergency Medicine, A Comprehensive Study Guide, ed 5, 2000, pp 1972-1982.

Gnann Jr JW, Whitley RJ. Herpes zoster. N Engl J Med, Aug 2002;347(5):340-346.

Swartz MN. Cellulitis. N Engl J Med. Feb 2004;350(9):904-912.

Palchak MJ, Holmes JF, Vance CW, et al. A decision rule for identifying children at low risk for brain injuries after blunt head trauma. Ann Emerg Med. Oct 2003;42(4):492-506.

Shah AJ, Kilcline BA. Trauma in pregnancy. Emerg Med Clin N Am. Aug 2003;21(3):615-629.

ACEP Clinical Policies Committee, Clinical Policies Subcommittee on Acute Blunt Abdominal Trauma. Clinical policy: Critical issues in the evaluation of adult patients presenting to the emergency department with acute blunt abdominal trauma. Ann Emerg Med. Feb 2004;43(2):278-290.

Turner TWS. Do mammalian bites require antibiotic prophylaxis? Ann Emerg Med. Sept 2004;44(3):274-276.

CRASH Trial Collaborators. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC crash trial): randomised placebo-controlled trial. Lancet. Oct 2004;364:1321-1328.

Schwartz LR, Balakrishnan C. Thermal burns. Emergency Medicine, A Comprehensive Study Guide, 2004, ed 6. pp 1220-1226.

Ufberg J, McNamara R. Management of common dislocations. Clinical Procedures in Emergency Medicine, 2004, ed 4. pp 946-963.

Thielman NM, Guerrant RL. Acute infectious diarrhea. N Engl J Med. Jan 2004;350(1):38-46.

Sarasin FP, Hanusa BH, Perneger T, Louis-Simonet M, Rajeswaran A, Kapoor WN. A risk score to predict arrhythmias in patients with unexplained syncope. Acad Emerg Med. Dec 2003;10(12):1312-1317.

McSweeney JC, Cody M, O'Sullivan P, Elberson K, Moser DK, Garvin BJ. Women's early warning symptoms of acute myocardial infarction. Circulation. Nov 2003;108:2619-2623.

Welch RD, Zalenski RJ, Frederick PD, et al. Prognostic value of a normal or nonspecific initial electrocardiogram in acute myocardial infarction. JAMA. Oct 2001;286(16):1977-1984.

Bates SM, Ginsberg JS. Treatment of deep-vein thrombosis. N Engl J Med. July 2004;351(3):268-277.

Jagoda AS, Cantrill SV, Wears RL, et al. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med. Aug 2002;40(2):231-249. (Note: The content of this reading also relates to Content Area 18, Traumatic Disorders.)

Kidwell CS, Chalela JA, Saver JL, et al. Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA. Oct 2004;292(15):1823-1830.

Anderson MR, Klink K, Cohrssen A. Evaluation of vaginal complaints. JAMA. Mar 2004;291(11):1368-1379.

Bjornson CL, Klassen TP, Williamson J, et al. A randomized trial of a single dose of oral dexamethasone for mild croup. N Engl J Med. Sept 2004;351(13):1306-1313.

Perelman VS, Francis GJ, Rutledge T. Foote J, Martino F, Dranitsaris G. Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial. Ann Emerg Med. Mar 2004;43(3):362-370.

Blumenthal D. Doctors and drug companies. N Engl J Med. Oct 2004;351(18):1885-1890.

The American Osteopathic Board of Emergency Medicine has a similar process.

Professional Status
Diplomats must maintain at least one valid, unrestricted medical license. This must be on file with AOBEM. Diplomates must also maintain continuous membership in the American Osteopathic Association, thus insuring that they meet CME requirements.

Continuous Osteopathic Learning Assessment (COLA)
Eight modules will be available over a ten year cycle. To be eligible for recertification, diplomates must take all eight modules over the ten year period and must pass at least 6. Taking and passing six will not qualify a diplomat to recertify. Each module will be available on the internet for 3 years. Candidates will have three tries at passing a module. Failure to meet these requirements will result in the Diplomate having to re-enter the full certification process.

Formal Re-Certification Examination (FRCE)
This one-day exam must be taken every ten years. The exam consists of a multiple-choice exam and an oral examination.

Practice Status
Diplomates must provide evidence of active practice of emergency medicine (clinical practice, administration, research, teaching, EMS, toxicology,…). Diplomates must provide AOBEM with a letter from the appropriate supervising body.

For more information go to http://www.aobem.org/continuous.htm.

© 2003 NJACEP