Preparing for this exam is preparing yourself to be an Expert Physician. Not only do you need to know the topics in the syllabus well, and have expert medical knowledge, you also need to know the Emergency Medical and Hospital System capabilities and limitations, inside out. You need to know when to take charge, and when to defer to someone better qualified to manage the situation at hand. The buck will stop with you, and you need to know what to do with it! Remember, this is an exit exam. Obtaining the FACEM qualification entitles you to be left in charge of the most chaotic, challenging, diverse and difficult of medical environments in the modern hospital system. Are you ready to “be the expert”?
Never mind the difficult airway or running an arrest, they’re the easy parts of the job. Here’s a few (of the many) real life situations I’ve been faced with as a Consultant that took expert skill to manage (hopefully de-identified enough not to implicate anyone or any hospital).
Treating a medical colleague for prescription drug abuse.
Treating a pop-stars mother for a psychiatric condition
Dealing with the fact that my entire (full) department may have been exposed to measles.
Being physically & verbally intimidated by a Paediatrician who disagreed with my treatment of a child! (I know… of all specialties, who’d have thunk?)
Managing an inpatient unit Consultant physician (as a patient) who’d been sent home with a potentially unstable spinal fracture, who I had to recall to my ED.
Dealing with a full department with 9 ramped ambulances, 45 patients in the waiting room, and no beds in the hospital…
I could go on, but do you get the picture? If any of the above scenarios seem beyond you, then you need to question whether you’re ready to “be the expert”. If the above scenarios excite you, and make you think “bring it on!” then maybe you’re ready…
Got any tips on “being the expert” for future FACEMs? Got any scenarios that tested your expert FACEM abilities?
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