The Levels of Eminence

Egerton Y. Davis IV spoke to an assembled horde of Genghis Khan‘s descendants in Ulaanbataar today, the first stop on the 2030 UCEM World Tour. He made a key announcement regarding the formation of the new Center for Eminence Based Medicine now operating under the auspices of the Utopian College of Emergency for Medicine.

Davis IV said:

“For too long medical professionals have been slaves to the Evidence Based Medicine Leviathan. Doctors are sick of hearing the constant refrain – “But what level of evidence supports that?” – emanating from Blackballers, wannabe Devil’s Advocates and downright annoying medical students whenever they make diagnostic or therapeutic decisions.

We at UCEM, like you, the practicing doctor, lament the stranglehold that this tyrannical rule has on our profession. Clearly we need to go back to the ‘good ole days’ and create a system by which we can simplify and clarify the justifications for our decision-making based on the things that really matter.

Fortunately, our prayers have been answered. UCEM is pleased to unveil the Center for Eminence Based Medicine’s new ‘Levels of Eminence’. Let the new golden age of Eminence Based Medicine begin!

Davis IV’s presentation compared and contrasted the Centre for Evidence Based Medicine‘s cumbersome system:

…with the new streamlined and practical system developed by UCEM’s Centre for Eminence Based Medicine:

Levels of Eminence Based Advice
  • Level 1 — Advice from Sir Hubert Ignatius Thompson III, UCEM President
  • Level 2 — Advice from an UCEM Council Executive Member
  • Level 3 — Advice from an UCEM Fellow
  • Level 4 — Advice from an UCEM Trainee (aka MUPPET)
  • Level 5 — Something you just made up
  • Level 6 — Advice from a member of a College of Medicine other than UCEM
Grades of Eminence Based Recommendation
  • A — Consistent Level 1 advice
  • B — Consistent Level 2 or 3 advice, or extrapolations from Level 1 advice
  • C — Consistent Level 4 advice, or extrapolations from Level 2 or 3 advice
  • D — Consistent Level 5 advice, or extrapolations from Level 4 advice
  • E — Consistent Level 6 advice, or troublingly inconsistent or inconclusive advice of any level

UCEM hopes the medical practitioners of the world will adopt this new system with the same enthusiasm as the expert bactrian camel herders of Outer Mongolia.

Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.

After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.

He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE.  He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.

His one great achievement is being the father of three amazing children.

On Twitter, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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