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From the first primary exam of the newly formed<br />
Australasian College for Emergency Medicine in 1984<br />
The exam was at the Alfred<br />
hospital, and Joe was<br />
convener of the primary<br />
exam committee.<br />
We had about 25 candidates,<br />
from all over Australia, and<br />
after the morning vivas (done<br />
with wet anatomy specimens)<br />
it appeared that there may be<br />
only a handful of passes, as<br />
the external examiners had<br />
been given free rein to ask<br />
any questions they wished.<br />
Surgeon Prof. Vernon<br />
Marshall asking about<br />
complex biliary anatomy and<br />
Mr Tony Buzzard (another<br />
surgeon) the intracranial<br />
course of the petrosal<br />
nerves – quite obscure<br />
anatomy and hardly relevant<br />
to emergency medicine.<br />
Over lunch we received a<br />
note from the Queensland<br />
candidates, expressing no<br />
confidence in the exam<br />
committee, as the questions<br />
were ridiculously hard<br />
and not from the ACEM<br />
informal syllabus. Tom<br />
Hamilton (the then College<br />
president) was furious.<br />
At the end of the day, when<br />
the exam panel met to<br />
evaluate the marks, the results<br />
were truly shocking: 6 passes<br />
from 25 candidates. Tony<br />
Buzzard leaned over to Joe<br />
in the chair and said, ‘Hmm<br />
Dr <strong>Epstein</strong>, does not look like<br />
this new College will get any<br />
new fellows for a while.’<br />
Joe leaned back, clearly<br />
somewhat shocked,<br />
and blurted out, in<br />
uncharacteristic fashion.<br />
‘But Tony, you surgeons<br />
don’t realise that emergency<br />
medicine is the first<br />
postmodern specialty.’<br />
The term meant nothing<br />
to them. However, they<br />
grudgingly relented on a<br />
few marginal candidates<br />
rather than request an<br />
explanation, and we saved<br />
face with ten passes.<br />
1To conduct the exam, we<br />
needed to deliver about<br />
20 wet (formalin soaked)<br />
cadaveric specimens to<br />
the basement of the Alfred,<br />
next to cafeteria 1. We<br />
were using cafeteria 2,<br />
normally unoccupied,<br />
as a function room.<br />
During morning tea time<br />
the busy cafeteria was full<br />
and the odour of formalin<br />
spread to the staff. There<br />
was some disquiet. Then<br />
the local shop steward (HEF<br />
No 1 branch; very militant)<br />
threatened to blockade the<br />
exam until the specimens<br />
were removed – a catastrophe<br />
for the first ACEM exam.<br />
Joe took him aside and<br />
pointed out we were a young,<br />
poor College. Coincidentally,<br />
that morning’s Age had a<br />
story on the car park death<br />
of a 55-year-old woman<br />
discharged from ED after<br />
chest pain. Joe politely<br />
showed him this story – we<br />
had a copy in the examiners<br />
room – and explained that<br />
he was producing a type of<br />
doctor to perhaps prevent<br />
this happening to him, or<br />
his mother, and could he<br />
please bear the smell for a<br />
few more hours. Joe also<br />
gave him his home phone<br />
number, if any of his family<br />
should become unwell.<br />
A sweet smile. ‘Certainly<br />
doctor, go ahead, I shall speak<br />
with my members. This is too<br />
important for a small smell to<br />
worry us.’ Problem solved.<br />
Bryan Walpole | emergency<br />
physician, Tasmania<br />
33
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