When the American College of Surgeons (ACS) first published progressive recommendations about the importance of and need for organized emergency services, no medical specialties were willing to endorse these suggestions. The notion of a comprehensive emergency medicine (EM) discipline did not fit within the scope of any established conventional specialty, but members of the medical community continued their efforts to define EM as a legitimate specialty. In 1968, as patient demand for quality emergency care grew, a group of concerned physicians joined forces to found the American College of Emergency Physicians (ACEP). By 1970, the University of Cincinnati opened its doors to the first EM residency and during the decade, ACEP worked relentlessly to gain specialty status for these new graduates. Soon a core framework of knowledge and skills for EM was created; Annals of Emergency Medicine was launched; and an Interim Review Committee (IRC) was formed. Finally in 1979, the American Board of Medical Specialties recognized EM as medicine’s newest specialty.
In 1980, the American Board of Emergency Medicine (ABEM) oversaw its first certification examination. At first, ABEM delineated two tracks that new doctors could follow to become certified in EM: graduation from an IRC-approved residency program, or interim practice for those who were not formally trained but had experience in EM. (The interim practice track was phased out in 1988.) Today, to maintain qualifying standards, ABEM requires recertification every ten years and has recently established continuous certification that involves annual education updates for EM physicians.
Since the establishment of the EM specialty, utilization of emergency services has steadily grown, increasing, for example, 23% from 1992 to 2002. Public awareness of EM as a specialty, consumer expectations of rapid and comprehensive emergency care, difficulty accessing primary care, lack of medical insurance, and federal mandates requiring emergency rooms to treat all patients regardless of status have all contributed to this increase.
1. The passage suggests which of the following about medical professionals who wanted to practice emergency medicine after 1990?
(A) They could not fill the demand as utilization of emergency services increased.
(B) They, unlike their counterparts in other medical specialties, had to go through certification to be properly qualified to perform their duties.
(C) They could only become board-certified through an accredited residency program.
(D) They may have worked in emergency rooms, but they were not necessarily educated in an approved residency program.
(E) They face some of the most challenging and life-threatening situations, which is why they need to be highly prepared and qualified.
2. According to information contained within the passage, all of the following were efforts that helped sway opinion about the specialty status of emergency medicine EXCEPT
(A) A coalition of doctors united to voice their concerns.
(B) A specialty journal was published.
(C) Guidelines and criteria were outlined for emergency practitioners.
(D) Medical schools nationwide introduced EM residency programs.
(E) A review committee was established
3. In the passage, the author is primarily concerned with
(A) outlining an unconventional approach to resolve a concern
(B) discussing the steps taken to accomplish an objective
(C) advocating the importance of challenging convention
(D) evaluating methods used to legitimize a specialty service
(E) explaining why a new specialty is needed for effective patient care
4. The final paragraph functions in the context of the entire passage to
(A) discuss what that influenced emergency medicine as it became its own specialty
(B) present reasons that contributed to patients’ increased use of emergency health care
(C) introduce a new subject that is not relevant to what was discussed earlier
(D) point out issues that physicians who are deciding whether to practice emergency medicine as a specialty need to consider
(E) outline some of the factors that many physicians cited when they campaigned for emergency medicine to be its own specialty
