Proposed EM/Anesthesia Combined Residency

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bcmak

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http://link.springer.com/article/10.1007/s40140-015-0130-9

Has anyone seen this article? It proposed a combined EM/Anes residency and compares it to the IM/Anes and IM/EM combined residencies.
Thoughts? Plausible?

***If the link doesn't work there's a PDF attachment as well.

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  • The Anesthesiology-Emergency Medicine Combined Residency.pdf
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Scientifically it makes sense, to me. Critical care shares a lot of anesthesiology principles, and anesthesiology has a large neuropharmacology component.

A good resuscitative ER/anesthetist could accordingly reduce the most common adverse effects (e.g. neurodegeneration) in that setting; I believe that a lot (most?) of cardiac events cause secondary brain damage. So, a combined anesthetist/ER could not just stabilize the patient, but improve their quality of life post-recovery.

Maybe it's only a modest percentage (e.g. 5%), but that's 5% of your brain function, and it would lower at point and follow up care costs, which could be huge. Also, it looks like the resuscitative role they describe involves coordinating with ICU, radiology, and surgery departments and that would streamline the transition of patients between them.
 
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This article is not very helpful. It is written by 2 anesthesiologists as an opinion piece on what a combined residency in emergency medicine/anesthesiology should contain. I'm not sure how it made it past the peer review process. I also do not know why these two authors couldn't have bothered to ask an emergency physician to serve as a 3rd voice so that they could at least have an EM perspective. Looking over their proposed training, I am not sure what the "non-acute" emergency department is. I hope they aren't suggesting that we spend 5–6 months in an urgent care center.

My complaints aside, I do think that such a combined residency might have its place, as the authors say, for a resuscitation expert, although I think the same goal could be obtained by completing a fellowship in critical care. I imagine most EM programs will avoid the combined route given the high demand for emergency physicians and the desire to push out grads as quickly as possible.
 
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Anyone hear any rumblings of which sites are applying for this program? Looks pretty interesting.
 
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