1970: The First EM Residency
The same general circumstances that forged ACEP also led, independently, to the first emergency medicine residency program. The University of Cincinnati Medical School worked with a large city-run hospital, Cincinnati General. The General abutted a large and under-served neighborhood accounting for many of the 100,000 annual visits to its emergency department.
In 1967 a young internist and hematologist named Herbert Flessa began talking with the hospital chief of staff about improving emergency care through better education. Conversations with the AMA’s Council on Education led to Flessa penning a white paper on training the emergency physician. Suddenly a national expert, Flessa found himself in the winter of 1970 meeting the ACEP founders at AMA headquarters in Chicago.
The AMA officially approved Flessa’s proposal for a general practice residency with an emphasis in emergency medicine. In July of 1970 Bruce Janiak began residency training in emergency medicine. Most of his rotations were officially off-ward, but he gave them an emergency focus. For example, while doing orthopedics he spent most of his time in the emergency department pinning knees and putting hip fractures in traction.
Despite its bootstrap origins and early organizational turmoil, Cincinnati remains an elite emergency medicine program.