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A Day in the Life of an Emergency Medicine Fellow as Told by Dr. Chris Gilsdorf, DO

Chris Gilsdorf, DOI am an emergency medicine fellow at the University of Tennessee Medical Center in Knoxville. I discovered the program while applying to residencies in family medicine. The family medicine program at UT Medical Center felt like an excellent fit when I interviewed there, and the EM fellowship program was the proverbial cherry on top. Over the next three years, I had numerous opportunities to work closely with both the emergency department faculty and staff, and with Dr. Lamsen, the EM fellowship program director and a previous graduate of our family medicine program. I was very impressed by the simulation center, greatly enjoyed working with the attending physicians at UT Medical Center and was lucky to have access to all the resources inherent to a Level I trauma center.

In the fellowship, on average, I work about five days a week. This varies depending on my schedule, or if I am on an off-service rotation. Our shifts in the emergency department at UT Medical Center are all 12 hours. We also work three 8-hour shifts a month at East Tennessee Children’s Hospital. On average, I spend about 48 hours a week between both emergency departments.

The number of patients I normally see varies, though I average at least 12 patients per shift. I try to maintain a pace of 1.5 patients per hour, which is very attainable over several hours, though the ebb and flow of new patients can make this challenging over a full shift. I may see fewer patients than this on days with higher-acuity, higher-complexity patients, or with multiple procedures.

I feel that my primary care experience has helped me develop the skills to rapidly and efficiently treat and disposition patients with lower-acuity issues, as well as present a calm bedside manner to put patients at ease. My family medicine training has given me ample exposure to pediatrics and obstetrics, both of which are crucial to be a capable and well-rounded emergency physician.

I had worked in the emergency department at UT Medical Center for the three years prior to the fellowship, so there were few surprises in the practice of medicine there. However, I was surprised and gratified to discover, especially as my year progressed and I grew closer to the attending physicians I worked with, how collegial many of them proved to be. I experienced true mentorship on numerous occasions and support that will continue beyond the end of my fellowship. My attending physicians’ trust in me solidified throughout the year, and several would come to treat me as a colleague or even a friend.

If you are a physician interested in completing an EM fellowship, you should expect most of your time in the program to be spent in the ED. You should also be prepared for weekly didactics sessions to supplement your on-the-job experience gained in the emergency department. I have found the hands-on simulation experience with models to strengthen procedural skills, and the opportunity to run through ACLS scenarios in a no-consequences situation, to be exceedingly beneficial. Scholarly activity opportunities are encouraged and can be explored to even greater depth if this is an area of strong interest for you; I have found excellent mentorship among my attending physicians. If your fellowship program allows for opportunities to experience prehospital care, such as with our EMS colleagues, air ambulances, or the fire department, these can be very enlightening experiences, and help shed light on the interfacing between prehospital and emergency department care.

The EM fellowship at UT Medical Center is recognized by the American Academy of Emergency Physicians (AAEP) as a program that meets the high standards for physician certification developed by the Board of Certification in Emergency Medicine (BCEM). The BCEM is a Member Board of the American Board of Physician Specialties® (ABPS). For more information about BCEM certification, contact the ABPS.

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Medical organizations throughout North America understand that our rigorous certification standards prove that ABPS Diplomates are capable of delivering the best patient care possible.

Far too often, medicine is led by less than 5% of non-practicing physicians taking away and replacing the voice of the 95% of physicians practicing and placing patient safety and care first on the front lines every day. The American Board of Physician Specialties has raised the standards in physician board certification not only in the quality of their boards of certification, but in hearing and allowing for the voice of those active physicians caring directly for patients. Having been a part of the ABPS over the last 28 years has allowed me to grow as a woman leader in a field often wrought with challenges. It helped me and others raise the bar of the standards of care in my specialty, Emergency Medicine, through their Board Certification in Emergency Medicine (BCEM). ABPS also helped raise the standards of care for 21st century medicine through their certifications in other specialties, particularly in Integrative Medicine & Disaster Medicine. Having physician voices heard matters to medicine and is essential in the betterment of patient safety and care.

Sarah E. Gilbert, MD, FAAEP
Sarah E. Gilbert, MD, FAAEP
Emergency Medicine
On October 18, 2007, President George W. Bush released Homeland Security Presidential Directive 21 (HSPD-21), calling on our nation, among other initiatives, to “collectively support and facilitate the establishment of a discipline of disaster health”. It is a great testament to the wisdom and foresight of the American Board of Physician Specialties that it immediately set to work and created, within the short span of only one year, an educational blueprint and set of certification examinations, both written and oral, for a new subspecialty of disaster medicine—and it is why I chose to be part this vital initiative and this wonderful organization. This is but one of the many innovative programs initiated by the American Board of Physician Specialties over the years, and why I am proud to support its work on behalf of our nation’s public health.

Art Cooper, MD
Disaster Medicine
When the American Board of Physician Specialties offered to host the American Board of Integrative Medicine, ABPS became a landmark organization working to move medicine into the twenty first century. Certifying physicians who have completed rigorous academic training in Integrative Medicine ensures that the field of Integrative Medicine will continue to develop academically, clinically, and professionally. The leadership of ABPS continues to impress me - they are diligent in constantly innovating to provide certifications for physicians who want to advance their careers and their areas of expertise. I am honored to be a part of this organization.

Ann Marie Chiasson, MD
Integrative Medicine
There are many ways board certification advances a physician career. ABPS Board examination verifies your accuracy, precision, and reflects your mastery of your residency training verifying your expertise. ABPS Board certification demonstrates your level of expertise beyond your practice experience, primary education degrees, and training which are necessary for insurance reimbursement and practice privilege requirements. Attaining your ABPS Board Certification will clarify your purpose, secure your practice growth, and expand into leadership positions. Board certification can serve as an indication of a physician’s commitment to medicine, beyond the minimal standards and competency of training, their measurement to quality of care, and attaining an award for excellence.

Chris Kunis MD
Internal Medicine
When I think historically, advancement in medicine and patient safety and care has been driven by the diversity of people and scientific thought. That’s what I found at the ABPS and more. For over 60 years that is just who we are. I found a physician certifying body that provides a choice and voice to all physicians ensuring that patients are always placed first.

Jerry Allison, MD
Emergency Medicine
When I decided to pursue a full time role as a physician executive it was important to me to obtain additional professional training, education and work experience. Board certification through the ABPS in Administrative Medicine is validation of my efforts and a demonstration of dedication to professional development. We need more physicians to become full time health care executives, knowing there is a board certification option in Administrative Medicine encourages physicians to take the leap from full time clinical practice to healthcare organizational leadership.

Richard Paula, MD
Administrative Medicine
The American Board of Physician Specialties has provided me with the opportunity to demonstrate mastery of internal medicine through board certification. As a hospitalist, board certification is an expected credential, and hospitals recognize the American Board of Physician Specialties (ABPS) as one of the three standard credentialling bodies for Internal Medicine. Additionally, the ABPS has helped me develop leadership skills as a Board member and Committee Chairperson. ABPS has also helped me sharpen critical thinking skills as a test question developer and reviewer. The Allopathic (MD) and Osteopathic (DO) physicians in the ABPS are lifelong learners and frequently pursue multiple board certifications. I enjoy the camaraderie of my peers in ABPS.

Loren Jay Chassels, DO
Internal Medicine
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