The ALLNYCEM Spring Conference, at The New York Academy of Medicine. This year’s theme — Women’s Health and Emergency Medicine — brought together leaders in emergency medicine, advocacy, and education to address issues of women health in emergency medicine, and as an added bonus, gave an overview of the new ABEM oral boards! Today's presentations featured our own Dr. Julie Cueva and Dr. Smruti Desai, along with Maimo EM alum Dr. Sabena Vaswani. Here is a recap of the day!
Welcome and Introductions
Dr. Laura Melville (NYP-BMH) and Dr. Diksha Mishra (NYP-Cornell) set the stage for a day focused on equity, advocacy, and excellence in women-centered emergency care.
FemInEM is Back!
Dr. Dara Kass (FemInEM)
Reintroduced FemInEM's leadership team and core mission: equity, mentorship, research, and clinical innovation.
Announced new initiatives including updates in reproductive healthcare in Texas and a Women in Medicine Summit (Sept 18–20, 2025).
Encouraged participation in advocacy and leadership programs.
Rethinking Chest Pain in Women
Dr. Julie Cueva (Maimonides)
Women comprise 57% of ED chest pain visits but receive delayed and differential care
Are less likely to receive an early EKG
Wait an average of 11 minutes longer than men to be evaluated
Have higher rates of major adverse cardiovascular events (MACE)
Only 30% of STEMIs in ED patients occur in women — often under-identified
High cardiovascular disease (CVD) burden: CVD is the leading cause of death in women
1 in 3 women die of cardiovascular-related illness
Traditional risk tools may underestimate women's risk, especially premenopause or perimenopause
Less likely to report classic "crushing" chest pain
More likely to present with: Jaw, neck, back pain, Exertional symptoms or fatigue/malaise, Shortness of breath, nausea, or palpitations
Women more commonly present with ACS mimics, including:
MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries)
Etiologies include coronary vasospasm, thromboembolism, SCAD, microvascular dysfunction
Treated based on etiology: antiplatelets, statins, CCBs, ACEi, BB
SCAD (Spontaneous Coronary Artery Dissection)
Seen in women ages 24–89, often peri- or post-menopausal
Avoid anticoagulation; treat with DAPT and beta-blockers
Takotsubo Cardiomyopathy (Stress-Induced)
Diagnosed by cath and echo
Managed with ACE inhibitors, beta-blockers, and supportive care
Endocrine and life-phase considerations: Estrogen is cardioprotective, but also prothrombotic
Consider cardiovascular pathology across age brackets:
Premenopausal: PE, autoimmune vasculitis
Perimenopausal (~40s): ACS, PE, breast pathology
Menopausal (~51+): ACS, aortic pathology
Advocate for sex-specific troponin thresholds and protocols
Improve documentation of atypical symptoms
Educate colleagues on female-specific risk factors (e.g., gestational HTN/DM, early menopause, PCOS)
Support gender-specific decision-making tools and diagnostic pathways
Reproductive Health in the ED
Dr. Sabena Vaswani (NYP-Q)
The ED is a key access point for reproductive health care, particularly for underserved populations.
ContraceptED is a framework for emergency clinicians to counsel and initiate contraception in the ED.
Same-day options include progestin-only pills (OTC), combined hormonal methods (pill, patch, ring), and Depo injection.
Use CDC MEC criteria to determine safe prescribing based on comorbidities and patient history.
Bridge patients to LARC (implants, IUDs) with prescriptions and follow-up referrals.
Initiate medication abortion for patients eligible and interested: mifepristone + misoprostol protocol.
Manage early pregnancy loss with patient-centered language and shared decision-making.
Counsel on HIV prevention and prescribe PrEP to high-risk patients when indicated.
Offer expedited partner therapy for STI treatment with take-home prescriptions.
Reframe reproductive health as essential emergency care, not a separate or optional service.
Beyond Microaggressions
Dr. Smruti Desai (Maimonides)
Interactive session on how to recognize, respond to, and grow from moments of bias
Microaggressions are subtle slights that undermine psychological safety and reinforce bias.
Impact matters more than intent—harm can occur even without malicious intent.
Prepare to intervene with the same mindset as a safety check: is the scene safe and private?
Effective responses include microaffirmations, clarifying questions, and naming behaviors—not people.
Assume best intent but always redirect attention to the impact of the statement or action.
Stay calm and disarm defensiveness—frame your feedback as an invitation to growth.
Support colleagues targeted by microaggressions with follow-up, validation, and direct intervention.
When called out yourself, respond with humility: pause, apologize, reflect, and adjust.
Promote institutional DEI efforts through skill-building, not just policy statements.
Practice allyship as an ongoing process that requires reflection, action, and resilience.
Gender-Based Violence and Strangulation
Jennifer DeCarli, Esq., LMSW (Deputy Commissioner, ENDGBV)
Gender-based violence (GBV) includes intimate partner violence (IPV), sexual violence, stalking, trafficking, elder abuse, and female genital mutilation (FGM).
NYC Family Justice Centers (FJCs) provide wraparound services for survivors across all five boroughs.
In 2023, NYPD reported over 245,000 domestic incident reports; FJCs saw more than 57,000 client visits.
Homicide data shows 32 intimate partner homicides and 41 family-related homicides in 2023 alone.
The HOPE domestic violence hotline received over 87,000 calls last year.
Medical providers are often first responders—strangulation must be recognized as a high-risk, high-lethality indicator.
Documenting non-visible injuries (e.g., hoarseness, petechiae, dysphagia) is critical in EDs.
Multidisciplinary collaboration between healthcare, law enforcement, and advocacy agencies improves survivor outcomes.
Mandatory reporting is complex—know state-specific laws and always center patient autonomy and safety.
Emergency departments are uniquely positioned to initiate trauma-informed, life-saving interventions.
Knocking on a Closed Door: Emotional Intelligence in EM
Dr. Shorok Hassan (SIUH)
Emotional intelligence (EQ) is the ability to recognize, understand, and manage your own emotions while navigating those of others.
EQ is composed of five key domains: self-awareness, self-regulation, motivation, empathy, and social skills.
Self-awareness allows for insight into your strengths, limitations, and emotional responses during clinical care.
Self-regulation means pausing before reacting, managing stress productively, and staying adaptable under pressure.
Motivation involves setting personal goals and aligning your work with values and purpose.
Empathy is the cornerstone of EQ—connect with patients and colleagues through genuine understanding.
Social skills include teamwork, verbal/nonverbal communication, and conflict resolution.
The Johari Window model helps identify blind spots, hidden strengths, and areas for growth.
Reflective practice enhances your ability to remain mindful, reduce bias, and avoid burnout.
EQ is a leadership skill—high-EQ clinicians build trust, improve team dynamics, and deliver better patient care.
Telehealth Abortion Management
Drs. Langan, O’Callaghan, Nadas (NYC H+H)
Nearly two-thirds of all abortions in the U.S. are now medical abortions, most initiated via telehealth.
NYC’s post-Dobbs policy response includes building telehealth hubs for abortion access through ExpressCare.
Mifepristone (REMS-restricted) and misoprostol are the two medications used in safe, effective early termination protocols.
No-test medication abortion is supported by ACOG, WHO, NAF, and studies showing 95% success and <0.3% complication rate.
Aiken et al. 2021 cohort study confirms safety of mail-in and virtual abortion services.
The Reproductive Health Act (2019) legalizes abortion in NY and allows advanced practice clinicians to provide care within scope.
Legal protection varies by state—ED clinicians must be aware of cross-jurisdictional issues, especially for traveling patients.
Survey data show that while 70% of EM clinicians support abortion care in the ED, only 10% feel trained to provide it.
ExpressCare infrastructure integrates scheduling, documentation, and virtual visits through Epic/MyChart/Bluesky platforms.
TeleMAB in NYC expands equitable access and reduces geographic, economic, and legal barriers to reproductive autonomy.
ABEM and the New Oral Boards
Dr. Theodore Gaeta (ABEM Board of Directors)
ABEM is transitioning to a new oral board format designed to better assess clinical reasoning and judgment.
The exam features updated content areas and structured interview formats aligned with modern EM practice.
Candidates will complete a series of structured cases with standardized prompts, focusing on safety, efficiency, and communication.
Core competencies tested include diagnosis, management, disposition, interpersonal skills, and patient-centered care.
Scoring rubrics are more transparent and emphasize reproducibility and fairness.
Preparation strategies should include structured practice, case-based group sessions, and mock exams.
Simulation and role-play are essential tools for improving confidence and pacing under exam conditions.
Programs are encouraged to build peer-led oral board prep initiatives for residents and recent grads.
ABEM provides official study resources and updates through its portal—residents should review regularly.
