Faculty members in EM choose this profession, and their career roles, for a variety of reasons. For some, it is the simple desire to educate and train future physicians. For others, the personal and career opportunities offered by a career in education make this an attractive option. In some specialties, a variety of rewards have been used to stimulate faculty teaching. These include financial incentives, educational opportunities, gifts, teaching awards, special recognition events, and appreciation letters [1, 2]. The chance to gain and develop other professional and leadership skills, such as presentation skills, conflict resolution techniques, business communication skills, and project management tools, provides a career balance that helps to maintain motivation and job satisfaction for many educators. Also, the opportunity to complement an active role in clinical care and teaching with official, educational, and research activities can be a strong motivator.

Many medical schools and institutions award tangible motivation in the form of wall plaques and teaching opportunities, but internal motivation seems to be a stronger force in the decision to teach [2–4]. Similarly, financial incentives for teaching positions usually are not as great as those in private practice [5, 6]. Finally, the opportunity to be a part of, and to interact with, a dynamic teaching faculty within a program, department/division, or institution can be a strong motivator. Associating with colleagues sharing similar beliefs, goals, and attitudes toward teaching and mentoring residents and students are key components of the academic environment.

Early in an academic career, a medical educator typically focuses on activities related to core medical knowledge. In many instances, this physician either is preparing for or has recently completed the board certification examination in EM. This provides fertile ground for teaching activities focusing on core knowledge and skills. Teaching activities early in one’s career encourage the development of a variety of administrative skills, including education and curriculum planning, negotiation and communication skills, learning to function amid organization politics, and time management and personal development goals. Success in early career activities can set the stage for future leadership positions such as medical student rotation directors, residency/specialty training program directors, departmental chairs, institutional/medical school leadership (e.g., dean’s office) positions, and leadership roles in local, regional, national, and international organizations. Creating and running a successful educational session, class, or program is a fundamental step in faculty development. The transition to subsequent stages of a medical education career requires different goals, activities, and skills.

In mid-career, an individual’s goals usually change, which is reflected in educational and teaching activities. By this point, individual skills, including teaching in one-on-one situations, small groups, and large-group sessions, have generally developed to a level of proficiency, and the focus often shifts to coordinating group educational activities, taking leadership roles for expanding and improving other faculty members’ teaching skills, and developing educational curricula and programs. Individual teaching and skills continue to be a focus, but these physicians find themselves to be subject-matter experts with regard to medical education and teaching and often seek academic activities that highlight their unique skills and experiences.

Course directorships and other leadership roles are part of the natural evolution of the medical educator’s career during this phase. These physicians have been involved in education long enough to know the basics and understand the common pitfalls to avoid to ensure success. They become excellent resources for junior faculty members and can serve as mentors, collaborators, and role models. Competing administrative, clinical, research, and other interests can change individual career goals, but those interested in continuing a career focused on medical education develop opportunities to hone specific skills and might advance toward national and even international prominence.

The next stage of the medical education career usually involves publications, speaking engagements, and other high-profile activities. Physicians in this group are truly the cream of the crop and have the requisite skills and knowledge to be effective individual educators; they also have gathered the necessary influence and experience to become the true drivers of large-scale medical education activities and curricula. These master educators have time to develop individual educational philosophies and now have the sphere of influence needed to implement and disseminate their ideas.

Training the Doctors of Tomorrow

Considered the primary goal of academic faculty members, clinical and didactic teaching remains a primary purpose for the EM faculty. A major component of the traditional academic “triple threat” of patient care, education, and research, the training of tomorrow’s physicians is as important now as it has ever been. With rapid advances in medical technology and informatics, teaching in EM is, in some ways, more challenging as well. Walking the fine line between embracing the technologies of the future while maintaining a bastion of the clinical skills of the past, EM educators are able to provide medical students and physicians-in-training the best of both worlds. In many specialties, physicians proceed directly to testing for a multitude of patient presentations. In the emergency department (ED), the initial evaluation of a critically ill or injured patient still boils down to basic clinical skills. In many ways, emergency physicians and educators possess the broadest skill set for the evaluation of acutely ill patients. All of this benefits medical students, as the ED clerkship is often their first opportunity to evaluate undifferentiated acutely ill patients. This unique factor, in addition to the concentration and diversity of patient pathology seen in the typical teaching ED, makes a rotation or training program in EM an outstanding learning experience for physicians-in-training [7].

A natural extension of the key role of EM in medical education is the development of specific rotations. Master educators have led the transformation of these rotations into core components of the undergraduate medical education curriculum [8, 9]. Career development for educators focusing specifically on EM education of undergraduates has led to an appropriate body of knowledge and resources for continued improvements in this area [9, 10].

All of these efforts in undergraduate EM education reflect an increasing responsibility for the preparation of future generations of physicians to provide emergency care. While some physicians-in-training ultimately will choose careers in academic medicine and teaching, the majority of EM graduates proceed into careers in nonacademic hospital settings [11, 12]. Thus, the education provided by teachers in EM can influence the full spectrum of future academicians as well as community-based physicians. With this broad appeal, EM physicians are sought out to provide guidance for a wide range of future career options.

This role specifically benefits future emergency physicians via a mentoring process. Career guidance, with specific attention to the choice of rotations, schedules, postgraduate training programs, and career goals, are all part of the role of the EM educator [13, 14]. There is even a role for virtual advisors (via the Internet and email communications) through the Society for Academic Emergency Medicine, which enables faculty members to become mentors for students at institutions without EM residency programs [15].

Active mentoring occurs on all levels, and mentorship for clinician–educators in EM has been described [16]. In many parts of the world, EM is still in its infancy; therefore, critical mentorship and development will be needed for many years at all levels, from students to faculty to regional/national developers of training programs [17, 18].

Developing Areas of Specialty Interest

The burgeoning field of EM features a wide variety of subspecialty knowledge and skills. Teaching physicians are involved in various fields, from the formally acknowledged fields of pediatric EM, toxicology, emergency medical services (EMS), and critical care, for which subspecialty fellowships have been developed, to a host of other areas. Emergency ultrasound, administration, tactical EMS, medical informatics, and international EM have evolved to include fellowship training programs and thus require faculty with specific expertise and teaching skills in these areas. Within nearly every academic practice group, specific physicians are also known as the go-to people for questions regarding specific areas. These physicians attain knowledge through seminars, minifellowships, individual study, and continuing medical education courses, as well as attendance and participation at regional, national, and international meetings, such as those sponsored by the American Academy of Emergency Medicine, the Society for Academic Emergency Medicine, and the American College of Emergency Physicians in USA. Other major conferences include the biannual International Conference on Emergency Medicine and symposia sponsored by the International Federation for Emergency Medicine and the Mediterranean Emergency Medicine Congress. Subject-matter experts have unique skills and knowledge in emergency imaging, domestic violence treatment and education programs, cardiovascular and neurologic emergencies, quality assurance and process improvement activities, medicolegal and risk management processes, geriatric issues, and women’s health issues, among others. An area that spans multiple specialties is emerging as an area of great strength for EM educators. Medical simulation offers the challenge of integrating medical knowledge, attitudes, and skills in case scenarios, procedure-based learning activities, and role playing [19]. This area should be an important focus for EM education in the future.

With specific educators having advanced knowledge in these areas, opportunities for focused education for medical students and residents abound. One of the first steps in attaining long-term success in medical research is development of a focused knowledge base or niche expertise. This generates research questions that can ultimately lead to studies and other activities. This generation of specialty-specific research has been one of the goals of the specialty of EM since its inception [20, 21].

Forming the Backbone of Local, Regional, National, and International Organizations

EM educators are often leaders in clinical and research activities as well as within their institutions and communities. Being a part of cutting-edge research and patient care activities uniquely positions EM educators to be leaders and participants in a variety of organizations. From an academic standpoint, EM educators interact with students, physicians-in-training, and faculty from nearly every other specialty. This familiarity aids EM educators interested in leadership positions within their departments or divisions and in advancement within the educational and administrative hierarchy of their institution and/or university. From a specialty and political standpoint, the leadership skills gained by interactions within local institutions as well as the structured nonclinical time inherent in EM training programs provide opportunities for advancement in regional and national specialty organizations, in addition to medical organizations that cross specialty lines or represent medicine as a whole. Finally, from a community standpoint, the EM educator often has valuable skills in administration, leadership, and project management. This makes them prime candidates for leadership positions within community groups.

Defining the Standard of Care

The fundamental process of teaching leads to increased critical appraisal of the medical literature and current practices and procedures. Faculty members in teaching roles help define the standard of practice in EM. A key subset of EM practice encompasses procedural skills. Teaching physicians are often innovators of new techniques, approaches, and equipment for procedures. Simulation-based medical education is an area of intense interest [19, 22, 23]. The focus on simulation-based education leads to improved patient care, while applying principles of crew resource management and analysis of medical and systems errors. Educators in EM have also been proactive in designing specific curricula for programs covering patient safety and error reduction [24].

Teaching physicians tend to be innovators in developing patient care practices, protocols, and procedures, which define the standard of care in EM. Emergency ultrasound is an example of this type of process. Innovators in EM education are helping shape the general medical school curriculum of the future through the integration of ultrasound teaching programs [25]. There is a natural association between research and continuous performance improvement because projects led by EM educators are often linked to changes in patient care. Postgraduate training programs and medical student educational experiences allow interaction between established educators and researchers and talented new medical professionals. This allows the formation of a dynamic organization geared toward producing new knowledge and practices.

Emergency Medicine Education: Foundations for the Future

Perhaps the longest reaching effect of teaching in EM is the joy of seeing students and physicians-in-training from years past succeed and grow to become the next generation of practicing emergency physicians. The role of a teacher is not always an easy one, but the benefits are clear. Solid teaching skills and the ability to motivate and involve today’s EM learners will result in a stronger, more stable specialty and positively influence learners and patients for many years. One high point of EM education lies in the creation of the curriculum guiding all educational activities. In USA, the Model of the Clinical Practice of Emergency Medicine represents the hard work of educators, researchers, and administrators from multiple EM organizations in standardizing the goals of EM education [26]. Similar documents have been developed by the Royal College of Physicians and Surgeons of Canada, the College of Emergency Medicine in UK, and the Australasian College for Emergency Medicine [27–29]. The International Federation for Emergency Medicine has also published a curriculum for medical student education in EM [30]. The groups that developed these documents include educators who have devoted their careers toward improving EM education and practice for the future [31–33].

There are many reasons for teaching EM. Each physician has his or her specific reasons for participating. Most physicians have several motivators. For many, the desire to be actively involved in clinical, didactic, and research training for tomorrow’s emergency physicians appears to be a primary goal. Enhancing patient care and patient safety are common factors, as is the desire to guide and enhance the standards of patient care. The development of specific faculty interest areas, career and professional development, and interaction with a variety of professionals in teaching and administrative roles are significant motivators for some educators. While the specific reasons for teaching vary from person to person, the overriding goals of advancing our personal and professional lives and advancing the specialty of EM appeal to all.