In the early 1980's, several dedicated emergency physicians initiated efforts to establish a Specialty Training Program in Emergency Medicine at the University of Alberta. At that time, the discipline of Emergency Medicine had no official status within the Faculty. In January 1983, Dr R. Burns, president of the Edmonton Emergency Physician's Association (a freestanding organization established by Dr Terry Stetsko) wrote to Dr D.F. Cameron, Dean of the Faculty of Medicine, to inform him that the membership had unanimously passed the following resolution:
Be it resolved that EEPA recommends the establishment of a Department of Emergency Medicine to train candidates for the Royal College examinations, and to provide one year of training in emergency medicine to Family Medicine residents.
In January 1986, Dr Cummings, Dr Neal and Dr Chernwichan established a subcommittee to pursue the establishment of a Residency Training Program in Emergency Medicine. Dr G. Goldsand, Associate Dean for Postgraduate Medical Education, acknowledged the formation of the subcommittee. However, he cautioned the group that the Royal College and individual faculties were very carefully reviewing the justification for the establishment of new programs, particularly because provincial governments had frozen funding for new training positions. Dr Goldsand also indicated that any new programs must take positions from existing programs, and that this would require strong justification. Even so, the subcommittee pressed on, preparing the initial Royal College "Application for New Program Approval" and submitting it for review by the PGME Internal Reviews Committee at their March 4, 1988 meeting. Although committee members generally supported the application, they felt that they could not forward the application to the Accreditation Committee of the Royal College until the following recommendations were addressed:
- Establish Departmental/Divisional status in the Faculty of Medicine
- Lobby and gain support of the Dean
- Lobby and gain support of the Associate Dean for Postgraduate Medical Education
- Try to establish, with Dr Goldsand's approval, funding in part from alternate sources
- Document the specific body of knowledge in Emergency Medicine that will benefit the University and the Faculty
- Solidify the academic base of clinical teachers involved with the program
- Address specific deficits in the document
The subcommittee made considerable efforts to address the recommendations. The body of knowledge specific to the discipline became apparent in 1989 with the implementation of an Emergency Medicine curriculum for Phase III medical students. Due in large part to the outstanding efforts of Dr Marc Chernwichan, this teaching block, almost from the outset, received numerous accolades and awards from undergraduates. In 1990, largely due to prodigious efforts and incessant lobbying by Dr Carolyn Neal, the Dean established the first free-standing Division of Emergency Medicine in Canada. Dr David Shragge was appointed as the Acting Director of the newly formed Division. He provided tremendous leadership and vision until 1993, when Dr Brian Holroyd was recruited as the first Divisional Director.
On October 9, 1991, the PGME Internal Reviews Committee reviewed the second draft of the new program application for submission to the Royal College. The application was once again sent back for refinement and reworking. To address the identified concerns and recommendations, Dr Shragge established a formal Residency Training Committee in April 1992, consisting of the following members:
- Dr Terry Sosnowski (Chairman)
- Dr Stan Poplawski (Grey Nuns Hospital)
- Dr Garnet Cummings (Royal Alexandra Hospital)
- Dr Dennis McElgunn (Royal Alexandra Hospital)
- Dr Ivan Steiner (University of Alberta Hospital)
- Dr Marc Chernwichan (University of Alberta Hospital)
- Dr Gordon Chaytors (Postgraduate Education Director - Family Medicine)
- Dr Michel Boulanger (Misericordia Hospital)
- Dr David Moores (Chair, Department of Family Medicine)
- Dr David Shragge (Acting Divisional Director)
Dr Sosnowski and Dr Steiner were appointed as the Program Directors for the proposed RCPSC-EM and CCFP-EM Training Programs respectively and, given the direction from Dr Goldsand, undertook to establish a common administrative structure for the two Programs, including a common Residency Training Committee.
By August, 1992 the Division and the Residency Training Committee had achieved the following significant milestones:
- The Dean pledged $10,000.00 per year towards the establishment of a Royal College Training Program in Emergency Medicine
- The Department of Family Medicine pledged $6000.00 per year towards the establishment of a CCFP-EM Training Program
- Dr Goldsand, in his capacity as Associate Dean for Postgraduate Medical Education, committed three first-year entry-level positions for the Royal College Training Program for the 1993/1994 academic year
- The Department of Family Medicine indicated a willingness to fund at least four positions per year for the CCFP-EM Training Program
Finally, verbal assurance was received from Dr Howard Platt at Alberta Health that, despite their recent decree not to duplicate "small" programs in Edmonton and Calgary, they would not stand in the way of our application
In August, 1992, Dr Sosnowski wrote to all the emergency physicians in Edmonton asking for financial contributions to assist in the establishment of Royal College and CCFP Emergency Medicine Training Programs at the University of Alberta. He stressed that a narrow window of opportunity had been afforded with the tentative support from the Faculty and Government and, given the difficult political and financial environment at the time, it was critical that this opportunity be seized. He pointed out that it would be truly unfortunate if such a fine cadre of emergency physicians were not afforded the opportunity to participate in the academic development of future emergency physicians. He also questioned whether the discipline could survive and maintain political strength in those difficult times without a strong and credible academic base. Finally, Dr Sosnowski pledged that with this startup support, the Residency Training Committee would make every effort to develop the best training programs in the country. It is a tribute to them that, despite the financial pressures at the time, the emergency physicians embraced this initiative and each contributed $1000.00 per year from their clinical earnings for a number of years. Given the success of the training programs and the achievements of the residents and the graduates, it is clear that the return on this investment has been substantial, and that the community, the Regional Health Authority, and the Faculty have benefited immeasurably.
A revised "New Program Application" for the Royal College Training Program, prepared by Dr Sosnowski, was submitted to the PGME Internal Reviews Committee in October, 1992. This submission met with the Committee's approval and was forwarded to the Accreditation Committee of the Royal College of Physicians and Surgeons for consideration at their January, 1993 meeting. The submission resulted in "New Program Approval" for a Residency Training Program in Emergency Medicine at the University of Alberta in 1993.
Resident recruitment for the 1993/1994 academic term began in earnest in October, 1992 in anticipation of approval from the Royal College. This was a dual recruitment, to include three candidates at the PGY-1 level and three candidates at the PGY-2 level. From the outset, and continuing to the present, we have been fortunate in being able to recruit uniformly outstanding candidates into our Program. Emergency Medicine has established itself in Canada as a very desirable and highly competitive career choice for graduating medical students, attracting many of the best students in the country each year. The Program at the University of Alberta has quickly established itself as one of the best of the Canadian programs, conferring on us a competitive advantage during the CaRMS match each year.
Thanks to the tireless work of Dr Holroyd and many other staff members the Division of Emergency Medicine was granted full Departmental status by the University of Alberta in November 2004.
The Program underwent its first on-site survey by the Royal College in February 1999 and, based on the survey team's recommendations, was granted "Full Approval." During the exit interview, the survey team described the University of Alberta Program as "the one the other Programs in Canada would now have to aspire to."
Achieving such success over such a relatively short period of time speaks to the quality of the trainees we have been able to recruit, and to the quality and dedication of the teaching faculty in the Department of Emergency Medicine.