ABEM History

The following milestones describe highlights of the events that shaped ABEM's history.  More detailed information on each event is available upon request from the ABEM headquarters.

1960s and 1970s

Emergency Medicine (EM) conceived

First EM residency training program created

EM approved as a recognized medical specialty

ABMS approved ABEM as a conjoint board (modified)

The events that led to the establishment of EM as the twenty-third recognized medical specialty in the United States are intimately tied to changes in the health care delivery system.  In the early 1960s, the United States public began to demand improved quality of care in hospital emergency departments.  In response to this demand, hospitals developed full-time emergency services dedicated to providing quality medical care to patients with life- or limb-threatening conditions.  In response to this need, a number of physicians began developing the training and practice of EM.

To support this growing physician group, new organizations formed, such as the American College of Emergency Physicians (ACEP) and the University Association for Emergency Medical Services (UA/EMS), which is now the Society for Academic Emergency Medicine (SAEM).  These organizations became the focal point for emergency physician education and the development of high-quality training programs.

In 1973, the American Medical Association (AMA) sponsored a conference on physician education in emergency medical care.  This conference identified the parameters of undergraduate, graduate, and continuing education needs for EM.  In 1975, the AMA approved a formal section on EM.

In the early 1970s, many ACEP members began to discuss the possibility of EM becoming a recognized specialty.  Toward that end, the College developed the Committee on Board Establishment (COBE).  The Committee began the arduous process of setting forth the standards for credentials and certification in EM.

The American Board of Emergency Medicine (ABEM) was incorporated in 1976.  During this same period, there was increased interest in providing EM graduate training programs.  The UA/EMS and ACEP established the Liaison Residency Endorsement Committee (LREC) whose endorsement process patterned the Liaison Committee for Graduate Medical Education (LCGME) and used the AMA-approved standards for reviewing and accrediting graduate training programs.

In 1975, ACEP developed a voluntary membership assessment program to support the construction of a high-quality certification examination in EM and signed a contract with the Office of Medical Education Research and Development (OMERAD) at Michigan State University to oversee the development of this examination.  In 1977, ABEM administered a full-scale field test using the examination produced by COBE and OMERAD.  This examination used well-developed written item formats and a unique case simulation oral examination.

In 1976, ABEM submitted an application to the American Board of Medical Specialties (ABMS) seeking primary board status.  This application was referred to the Liaison Committee for Specialty Boards (LCSB), a committee comprised of AMA and ABMS representatives.  The LCSB conducted open hearings intended to elicit support or opposition to the application.  At the close of these hearings, the LCSB recommended primary board approval and sent the recommendation to its parent bodies.  The AMA Council on Medical Education approved this recommendation, but the ABMS defeated it.

At the suggestion of various ABMS members, representatives from other specialty boards held a lengthy series of discussions from which a recommendation emerged for a second application, this time seeking approval for a conjoint board (modified).  The LCSB hearings resulted in a recommendation for approval, which again was submitted to the parent organizations.  The AMA Council on Medical Education and the ABMS approved this application.

In September 1979, Emergency Medicine became the twenty-third recognized medical specialty.

The original ABEM sponsors were ACEP, AMA, and UA/EMS, in addition to the following seven specialty boards:

American Board of Family Practice (ABFP)

American Board of Internal Medicine (ABIM)

American Board of Obstetrics and Gynecology (ABOG)

American Board of Otolaryngology (ABOto)

American Board of Pediatrics (ABP)

American Board of Psychiatry and Neurology (ABPN)

American Board of Surgery (ABS)

Directors elected from the sponsoring specialty boards' nominees provided great assistance throughout ABEM's development.

1980s

First certification and recertification examinations administered

ABEM sponsors changed

ABEM approved as a primary specialty board

ABEM practice track closed

ABEM offered the first EM certification examinations in 1980 and certified its first diplomates in that year.

In 1986, the ABFP withdrew as a sponsor, citing its belief that ABEM should be a primary specialty board.

In May 1987, ABEM submitted an application to ABMS for conversion to primary board status.  The ABMS Assembly defeated this application by a vote of 52-48, with six abstentions.  Approval requires a two-thirds ABMS Assembly vote.  Following that vote, ABEM officers and directors engaged in a series of active discussions with its sponsors and other ABMS member boards, during which many of the issues and concerns raised by the 1987 application were clarified and resolved.

The time span of the practice track was included in the original 1976 application to the ABMS and was consistent with ABMS requirements.  This information was widely disseminated.  When the Board was approved in 1979, the practice track was implemented as outlined and terminated as promised in 1988, although applicants were given an additional two years to submit an application.  This process resulted in 15 years of opportunity for potential candidates.

On May 11, 1989, ABEM submitted a new application to ABMS for conversion to primary board status.  ABEM's sponsors and most other ABMS member boards supported this application.  On September 22, 1989, the ABMS Assembly voted unanimously to approve the ABEM application.  Ten years after the 1979 original vote making ABEM an ABMS member board with conjoint (modified) status, the American Board of Emergency Medicine took its place as an ABMS member board with full primary board status.

ABEM and OMERAD conducted field trials of 11 recertification examination methodologies in 1985 and 1986.  ABEM offered recertification for the first time in 1989.  Diplomates achieved recertification by one of the following evaluation methods:

•           Passed one of two of the designated evaluations used in the 1985 recertification examination field tests.

•           Passed the written recertification examination, oral recertification examination, written certification examination, or the oral certification examination.

ABEM contracted OMERAD to develop and present an annual workshop for ABEM item writers, beginning in 1985.  This annual workshop is now developed and conducted internally. 

ABEM contracted OMERAD in 1986-1987 to develop a high-level, formal training program for ABEM oral examiners, which has continued to expand with additional refinements.

1990s

Subspecialties were developed

Combined training programs began

ABEM sponsors changed

Bylaws changed

ABEM headquarters was designed and built

Daniel v. ABEM began

Oral recertification examination was discontinued

Longitudinal Study began

Website established

The chart-stimulated recall method was used as the oral recertification examination from 1989 through 1993.  That examination was discontinued in 1994 due to lack of diplomates’ interest.

In 1990, a physician who had not met the ABEM eligibility requirements sued the Board.  The suit was transferred to Federal Court in Buffalo, New York, and after solicitation, an additional 176 plaintiffs joined the suit.

Also during 1990, guidelines for five-year combined training programs were approved for Emergency Medicine/Internal Medicine and Emergency Medicine/Pediatrics.  Upon completion of these training programs, physicians can access the certification examinations in Emergency Medicine and Internal Medicine, or Emergency Medicine and Pediatrics.

Soon after receiving primary board status, ABEM began working with other ABMS member boards to develop subspecialty certification for ABEM diplomates.  Certification in four subspecialty areas is now available to ABEM diplomates who fulfill the specific eligibility criteria.  The table at the end of this document lists each subspecialty, when the ABMS approved it, the subspecialty sponsoring boards, and the date of the first examination.  For each subspecialty, the sponsoring boards choose one board to be the administrative board.

The ABOto withdrew as an ABEM sponsor in 1992 stating that it felt sponsorship was no longer necessary.

On June 12, 1993, ABEM dedicated a new headquarters building in East Lansing, Michigan.  The building is a unique design and represents the Board’s dedication to quality and high standards.

In February 1994, ABEM revised its bylaws to allow the number of ABEM directors to be set by Board action within the range of 14 and 19 directors.  The bylaws revision also identified a Board nominating committee to propose a slate of individuals to fill the vacated director seats.

In June 1994, ABEM initiated the Longitudinal Study of Emergency Physicians (LSEP) and recruited 1,008 emergency physicians to be lifetime participants.  The study gathers information on professional interests, attitudes, and goals; training, certification, and licensing; professional experience; well-being and leisure activities; and demographic information.  In 1996, ABEM initiated the ABEM Longitudinal Study of Residents in Emergency Medicine.  The participants complete an in-depth survey each year of their residency training and then join the LSEP as full-time participants.

In 1996, ABEM established a website on the Internet to enhance its ability to communicate with its constituents.

In the fall of 1997, ABEM established the Presentation to Training Programs (PTP) through which directors deliver information in person to all ACGME-accredited EM residency training programs on a rotating three- or four-year basis.  The purpose of the presentation is to enhance communications between ABEM and residents; to clearly identify ABEM as the premier certifying body in EM; and to answer the most important questions residents have about certification, training, and other issues in medicine and EM.

In 1997, a task force was appointed to define the context and processes by which a new Core Content for Emergency Medicine could be created.  The task force initially included representatives from the sponsor organizations, ABEM, ACEP, SAEM, and the Council of Emergency Medicine Residency Directors (CORD).  Representatives of the Residency Review Committee for Emergency Medicine (RRC-EM) and the Emergency Medicine Residents' Association (EMRA) were added as consultants following the first meeting.  ABEM was designated as the administrative organization for the project.

In 1998, as recommended by the first task force, the collaborating organizations charged a second task force, Core Content Task Force II (CCTF II), to develop a new source document for EM based upon a practice analysis of EM.  The National Board of Medical Examiners (NBME) was hired as a consultant to assist with the development and implementation of the practice analysis.

1999 to 2004

Executive Director changed

MOC development began

EMCC developed and initiated

Public website redesigned

Additional EM directors added to the Board

Director term extensions began

EM Model approved

ABEM headquarters remodeled

EM/IM/CCM training approved

25^th Anniversary

In 1999, ABEM established a permanent quality control component to the oral examination designed to assess examiner adherence to ABEM standards and to gauge inter-examiner reliability.

In February 1999, ABEM and ABIM approved guidelines for a six-year combined training program that, upon completion, provides physicians the option for triple certification in Emergency Medicine, Internal Medicine, and Critical Care Medicine (EM/IM/CCM).

In December 1999, after 20 years of service to ABEM, Benson S. Munger, Ph.D., retired his position as the first ABEM Executive Director.  Dr. Munger was recognized for his insight, skill, and focus on the importance of establishing and nurturing the ABEM family with his creativity, leadership, warmth, and other seminal contributions to the specialty.  In March 2000, Mary Ann Reinhart, Ph.D., was selected by a unanimous vote of the Board of Directors as the new ABEM Executive Director after a seven-month national search.  Dr. Reinhart began her work with ABEM in 1985 as a faculty member in OMERAD and joined ABEM in 1988.  She served in a variety of positions related to examination development and administration and research and served as Deputy Executive Director from 1995 - 2000.

The Board of Directors commissioned the Maintenance of Certification^© (MOC) Task Force in 1999.  Its goal was to evaluate current needs and trends in medical specialty recertification in order to recommend a new approach to recertification.  From the work of the Task Force, ABEM developed the Emergency Medicine Continuous Certification (EMCC) program.  The EMCC program is anchored in the ABMS MOC requirements for all member boards that were developed in conjunction with the Accreditation Council for Graduate Medical Education (ACGME) program designed to train and assess residents in specialty-specific components of competence.

EMCC is composed of the four ABMS MOC components:

Professional Standing

Lifelong Learning and Self Assessment (LLSA)

Assessment of Cognitive Expertise

Assessment of Practice Performance

EMCC replaced recertification January 2004, when ABEM implemented the first three components of EMCC.  The fourth component, Assessment of Practice Performance, continues to be developed.

On April 5, 2004, diplomates were granted access to EMCC Online, the interactive EMCC portion of the ABEM website wherein ABEM diplomates access a secure, personal homepage whenever and wherever they have access to the Internet.  EMCC Online is the primary source of diplomate access to EMCC activity. 

In conjunction with the development of EMCC Online, the ABEM public website underwent extensive development to create a new look and feel with a comprehensive library of user-friendly information. The new website was made available April 2004.

In February 2001, ABEM revised its bylaws to expand the scope of nominations for the EM director positions to the broad EM community and approved a change in the number of director positions linked to the sponsoring societies.  ABEM also adjusted the length of some EM directors' terms by one year in order to help assure, in an ongoing fashion that no more than three directors rotate off the Board in any one year.

The CCTF II received approval of The Model of the Clinical Practice of Emergency Medicine (EM Model) from sponsoring organizations in February 2001.  ABEM adapted the EM Model for use as an examination blueprint for all of the ABEM examinations, and the fall 2002 written certification and recertification examinations were constructed in accordance with the EM Model.

The six collaborating sponsor organizations agreed that the use and continued applicability of the EM Model should be assessed according to a prescribed timeline.  The 2003 EM Model Review Task Force reviewed the organizations’ comments on the EM Model and submitted a small number of recommendations, which were approved by the sponsoring organizations. 

In 2002, ABEM completed an extensive renovation of its headquarters building in East Lansing, Michigan, incorporating all building space for ABEM use.

In 2003, ABEM and ABIM approved the first six-year combined training program for EM/IM/CCM.

In 2004, ABEM implemented a new program to replace the former PTP.  The new program, called Residency Visitation Program (RVP), includes more options to share topics of interest with EM residency programs, faculty, and attending physicians.  These include meeting with the chief resident, faculty, department chair, or others identified by the program; meeting in venues identified by the program; and giving a presentation in an area of the director’s expertise.

July 1, 2004, through June 30, 2005, was designated as the official period during which ABEM celebrated its 25^th Anniversary.  Several events celebrating ABEM’s founders and ABEM’s many accomplishments were held throughout the year.

2005 – Present

Judge dismissed Daniel v. ABEM suit

ABEM sponsors changed