This is part 2 of my review of Dr. Rosen's 1979 article on "The Biology of Emergency Medicine" ( see part 1 ).

According to Dr. Rosen, there are 3 broad categories of ED patients

• The emergent
• The urgent
• The non-urgent 

We must know how to identify and prioritize these. Medical students and residents are poorly taught the differences. “There are two shocks to residents: not every patient is sick, and many patients are sicker than they first appear”, he writes.

There are 3 critical ingredients which define a valid residency experience, according to Dr. Rosen who trained in surgery

• Pathology
• Adequate faculty
• Adequate number of residents

Uniquely, the specialty of EM is not defined by diseases, but rather by the level of acuity. Per Dr. Rosen our most important responsibility in the ED is proper assessment and stabilization. As emergency physicians (EP), the proof of the diagnosis is not as important as the assessment and stabilization. He states, “The quality, appropriateness and timeliness of the initial care is the biology and responsibility of our specialty.” Thus, EM training cannot be learned under someone else’s service.

The article has many other important points that every EP should keep in mind. This article is at the top of my list of reading whenever I encounter a medical student interested in EM. Even though it was written many years ago, many elements still hold true in our profession.