Review: The Essence of Emergency Medicine

It was  a long day. After getting home from a late shift the night before, I was up at 4 to catch my 0530 train, and toddled off down to London. What, you may ask could be worth all that?



I spent the day at the Essence of EM course, run by Cliff Reid, one of the most well known faces of #FOAMed and EM internationally. As if that wasn’t enough, the rest of the faculty were made up of highly experiences EM and ICM doctors, including Dr Louisa Chan (consultant ICM/EM), Phil Hyde (Consultant PICU), and Dr Mike Clancy, until recently president of the College of Emergency Medicine.

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So what was on the agenda for the day? The latest EM literature? Some cutting edge new technique that has twitter all in a flap? No. While clearly a man of many talents, Cliff is best known in the #FOAMed world for speaking on the human factors that affect us every day in EM. These ideas and concepts are as vital as any clinical skills and knowledge, yet are notoriously difficult to teach and assess in today’s world of tick box assessments. Anyone who has heard Cliff speak will know how good he is at getting these ideas across, and will understand why I jumped at the chance to hear him talk  in person.


Story Time

Cliff and his colleagues told us their stories. Some were funny, some were inspiring, some tragic and deeply personal. These weren’t “see how awesome I am” stories. These were stories of the events that had inspired them, or mistakes they have made.



“How could I have done something so dumb?” – Cliff Reid

Hearing such experienced people discuss their mistakes openly and honestly prompted the candidates to open up about the events that have affected them. After all, we learn very little when we get things right. We learn when we screw up, or when a colleague leaves us for dust; that’s when we’re inspired to be better.

The theme of learning from errors and incidents ran through the day. Mike Clancy led a discussion on dealing with a colleague’s error. Presented as an opportunity for improvement, an error is the most valuable learning tool we have – provided we are committed to changing your practice, or the system, to ensure it doesn’t happen again.

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What kind of Emergency Physician do you want to be?

This leads us on to the second theme running through the day. This question was asked of us right at the start. The phrase ‘taking responsibility’ once a constant refrain. Take responsibility for your patients! Do all you can for them, don’t just move them on to become someone else’s problem. If the system you work in is preventing you delivering the best care possible, then take responsibility, change that system. If the patient in front of you needs a lifesaving procedure –  then step up.

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Put your patients first, don’t abdicate responsibility to other specialities if you feel patient care will be compromised. Learn to communicate with your colleagues and advocate for your patient. Don’t abdicate responsibility to the bureaucracy; there may be a four hour wait in minors, but the unwell patient in front of you should be your priority.

To hear Cliff and his colleagues talk like this is music to the ears of UK EP’s currently struggling through a difficult time in the speciality. I think many of us feel that the pressures heaped upon us are compromising our ability to look after our patients, and that the high level, patient focused kind of care that Cliff promotes is not feasible in a world of breaches and under staffed rotas. I found it inspiring to here those eminent in our speciality discussing these concepts, and to see that the majority of attendees on the day were consultants who will take these ideas home to their department.

We all had a great day, and I can only thank Cliff for his time and dedication (plus I think I owe him a pint). Should you get the chance to attend this course in the future, I can not recommend it too highly.


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Well earned drinks afterwards! Left to right: Mike Eddie, Duncan Roche, Louisa Chan, Cliff Reid, Reuben Griscti, Bijou Cherian, Richard Browne

Cite this article as: Gareth Hardy, "Review: The Essence of Emergency Medicine," in St.Emlyn's, June 7, 2013,

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