History of Emergency Medicine

It was 20+ years ago, Sept. 21, 1979, that the American Board of Emergency Medicine was recognized as a conjoint specialty. And it was 10+ years ago, Sept. 21, 1989, that emergency medicine became a primary specialty in the House of Medicine. 1999 has been full of anniversary celebrations, including the 25th anniversary of the national Emergency Medical Services Week (May), the 25th anniversary of the Emergency Medicine Residents' Association (November), and the 30th anniversary of the Scientific Assembly (October/November).

Emergency medicine had its beginnings as early as 1961, when four physicians in Alexandria, VA, formed the first group dedicated to providing care in an emergency department setting, which became known as the Alexandria Plan. Other staffing arrangements developed throughout the year and in the years to follow. Soon after, emergency physicians began gathering on an annual basis for an educational program, and ACEP (1968) and later Scientific Assembly (1969) were born.

John G. Wiegenstein, MD, said it all in the first ACEP Newsletter in 1969: "We are, in a sense, a new breed of doctors dedicated to a new concept of medicine." ACEP was still young when talks began about developing emergency medicine as a specialty. As a fledging field, emergency medicine faced a great challenge in establishing itself in the House of Medicine.

The first step toward specialty recognition occurred in 1973, when emergency medicine physicians obtained approval from the AMA to organize a provisional Section on Emergency Medicine. This set the stage for section representative to start sponsoring educational programs, and the section gained permanent status in 1976.

In the meantime, College representatives were developing a certification examination for emergency physicians, and the final version of a board exam was tested in 1975. The next year, ACEP adopted articles of incorporation for the American Board of Emergency Medicine, which would administer the exam.

In 1976, ACEP and ABEM began the process for establishing a primary board. The American Board of Medical Specialties (ABMS) rejected the application in 1977, saying that there was no support, or need, for a board in emergency medicine. Emergency medicine leaders persisted, and developed a proposal for a conjoint board consisting of representatives from other specialties, which became a controversy within ACEP.

Finally, on September 21, 1979, the ABMS Assembly approved the ABEM as a conjoint modified board and included it in the membership, recognizing emergency medicine as the 23rd medical specialty.

During his president's message that year, George Podgorny, MD, said, "What a sense of elation! There was in each of us a sense of satisfaction that we has worked in the College for a mutual goal, and we have accomplished that goal." Five months later, more than 600 physicians sat for the first emergency medicine board certification exam.

It would be a full decade before the ABMS granted ABEM primary board status, as a result of efforts be ABEM and its sponsoring bodies to fulfill the requirements. Primary board status was granted on September 21, 1989, 10 years later to the day that emergency medicine was first recognized as a specialty.

The specialty recently celebrated 30 years of organization when ACEP began it's third decade in August 1998. With so many milestones under its belt, emergency medicine now faces a new and challenging millennium.