Unsupervised Practice of Emergency Medicine by Non-Physician Practitioners

Originally approved April 2025

The American College of Emergency Physicians (ACEP) believes that the independent practice of emergency medicine is best performed by physicians who have completed American Board of Emergency Medicine (ABEM) or American Osteopathic Board of Emergency Medicine (AOBEM) certification or have successfully completed an Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA) accredited emergency medicine residency and are in the process of completing ABEM or AOBEM examinations.

Physician assistants (PAs) and nurse practitioners (NPs) serve as integral and valued members of the physician-led emergency medicine care team. However, they do not possess the training and expertise in emergency medicine to practice independently without supervision. ACEP believes that PAs and NPs should not provide unsupervised emergency medicine care. ACEP endorses the term “unsupervised” when referring to the independent practice of emergency medicine by non-physician practitioners, including, though not limited to, PAs and NPs.