CDEM unites EM community on LCME accreditation standard ED-15


Over the past few years, I have been increasingly aware of how Emergency Medicine, as a specialty, has been under-appreciated by national accreditation organizations, such as the Liaison Committee on Medical Education (LCME). The LCME essentially accredits all U.S. and Canadian medical schools and is sponsored by the AAMC and AMA. Accreditation standards address all aspects of medical student training and periodically gets revised.

This year, at the national AAMC meeting in Boston, there was a call for public comments on the proposed new ED-15 standard:

Standard ED-15
  • The curriculum of the educational program must prepare students to enter any field of graduate medical education and include content that will prepare students to recognize wellness, determinants of health, opportunities for health promotion, and symptoms and signs of disease; develop differential diagnoses and treatment plans; and assist patients in addressing health-related issues involving all organ systems and spanning the life cycle.
Annotation for ED-15
  • It is expected that the curriculum will be guided by the contemporary content from and clinical experiences associated with, among others, the disciplines and related subspecialties that have traditionally been titled family medicine, internal medicine, obstetrics and gynecology, pediatrics, psychiatry, public health, and surgery.
Did you notice the glaring omission of EM and EM-related skills from the wording? Meanwhile, EM is growing increasingly more popular amongst students and is rapidly becoming a required clerkship rotation in medical schools. Also, management of undifferentiated patients and many procedures are taught in the ED setting. Alongside the other specialties mentioned, we should be recognized as a "core" specialty within medical schools.


So, yesterday Dr. Dave Wald (Chair of CDEM) released an official letter on behalf of CDEM to the LCME. The proposed wording changes have the backing of the Alliance of Clinical Education (ACE) and the major EM organizations such as AACEM, AAEM, ACEP, CORD, and SAEM. I just posted it onto the CDEM website. If you'd like to read the well-crafted letter, you can download it here.


In brief, here are CDEM's official wording change recommendations (changes in red):

New Proposed Standard ED-15
  • The curriculum of the educational program must prepare students to enter any field of graduate medical education and include content that will prepare students to recognize wellness, determinants of health, and opportunities for health promotion, to recognize and interpret symptoms and signs of disease; to evaluate undifferentiated patients, to develop differential diagnoses and treatment plans; to acquire decision making skills in acute care situations, to formulate evidence-based management for chronic diseases, and to assist patients in addressing health-related issues involving all organ systems and spanning the life cycle.
New Proposed Annotation for ED-15
  • It is expected that the curriculum will be guided by the contemporary content from and clinical experiences associated with, among others, the disciplines and related subspecialties that have traditionally been titled emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, pediatrics, psychiatry, public health, and surgery.
Hopefully the LCME will take our comments into consideration and amend the new ED-15 standard to accommodate our suggestions. It would go a long way towards validating EM as a specialty, as we continue to grow in presence and importance in medical schools.
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