Firstly, because I have big shoes to fill. I thank Dr Clare Skinner for her tireless and consistent work as President over the last two years – and for her friendship and support.
I am also nervous because I really care about emergency medicine, and our people in it. I love the work we do as emergency physicians. I love our broad and diverse crew. We are all striving to provide the best care we can to our patients and the communities we serve, no matter where that is, because that is ultimately what this is all about – our patients.
For those of you I haven’t had a chance to meet yet, I will outline a little about myself. Like us all, I’ve had my fair share of ups and downs; successes and failures, things I’m proud of, and things where I know I could have done better.
I knew from an early age that I wanted to be a doctor. My high school career counsellor told me I would never make it and I should consider something else. This really hurt.  At first, I was upset. But then I got determined – I knew what I wanted to do. What do they know anyway?
As it turned out, they were quite correct! I just missed out on getting into medicine, and I ended up in dentistry. Fortunately, I ended up doing well in my first year and applied to transfer across to medicine – and was successful. I am eternally grateful for this, not least because as it turned out, I discovered I really hate halitosis!
When I became a doctor, I saw no openly gay doctors in senior roles. Through this, I learned what it was to be a minority and what goes with not being completely mainstream. Diversity is important to me. The saying, “You can’t be what you can’t see” resonates with me. I am happy to see the progress we have made as a society. It shows me that positive change is possible. So, we must keep the pressure up, and keep fighting.
I first focussed on obstetrics, then ophthalmology, before finding my way to emergency medicine. I like to tell people that I swapped a Porsche for a Commodore, but the reality is that I swapped a life of predictability and narrow scope, for a life of excitement and the ability to use all the skills I had learned, and to continue to learn new ones.
I became the Director of Emergency Medicine at Alice Springs when I was 38. The move to rural Australia has provided me with so many opportunities to get involved in planning and developing healthcare at the hospital level, the Territory Department of Health level and some time at the Commonwealth level. I would not have had the same opportunities at this stage of my life if I had stayed in a city. Working in a rural area is a richly satisfying and rewarding career option.
I also got involved in College work. This was a really great way to meet people who have common goals, a shared understanding of the world. I would encourage you to get involved. It’s a great way to meet new friends and have a say in where we are going.
So here we are in the here and now.
It certainly has been a very busy first month in College leadership, with issues we did not anticipate, and with extremely difficult, painful decisions to make.
There will always be passion, and differing opinions and powerful advocacy in our community. And I welcome this. This is what makes this crew so special. We are unique. We are from diverse backgrounds, beliefs and experiences.
I like to think of the College as a huge, extended family. There will be sibling rivalries, squabbles, impassioned arguments at lunch. We don’t have to agree on everything – and that’s okay. Differing opinions are a good thing and we need to be comfortable with this. I believe this make us stronger as a community.
But I encourage us all to remain respectful, civil and safe in how we engage with each other.
How do I see the next two years? After some truly intense years, I feel it is time to take stock. At the College, and as a speciality.  We need to have a look at who we are, what we do, what we offer the health system. How do we continue to provide excellent training and support to our trainees? And how do we build on that to train and support our non-FACEMs who work in emergency medicine? They are an essential part of our emergency medicine workforce, and we need to bring them with us.
How do we continue to maintain our skills through lifelong learning? We are a generalist speciality and I believe we need to stay that way. Developing skills in special interest areas adds to all of us, and the care we can provide in our departments, but we should all be able to look after whoever comes through the door, from cradle to grave. I think this is the most exciting, the most rewarding part of emergency medicine, and it defines us a speciality.
To support ongoing learning, in 2024 ACEM is introducing some important changes and improvements to the ACEM CPD Program, including the rollout of a new mobile friendly digital CPD platform.
Over the next few years, how do we continue to grow and support our Indigenous Fellows and trainees? How do we promote culturally safe care? Next year, the College will award the 10th Indigenous doctor with Fellowship. It is a start, and we must keep striving, as Australia and Aotearoa both have a long way to go to address health inequities.
Finally, at the College, how do we best attract and retain and support the staff that support us?
These are all things I plan on us examining together, over the next two years.

As 2023 ends, I want to thank you to every single one of you – FACEMs, trainees, SIMGs and all members – for everything you have done over the last year, and for everything you have poured into emergency medicine, and for everything you have given patients who needed care, across Aotearoa New Zealand and Australia.
Thank you to College staff, who work so hard to support us and the field of emergency medicine. Thank you to our colleagues and allies across the healthcare system, to government who understand the complexities of the health system and are trying to better it; thank you to other health bodies who are dedicated to working toward better. Thank you to media who carefully and publicly elevated healthcare issues, and thank you to all friends, family and whānau who supported us through this year.

However you celebrate (or don’t) at this time of year, I wish for all of you a gentle festive period, and new year. For many of us working in emergency departments, this time of year doesn’t always feel festive, and many of us don’t get a break. Please take care of yourselves, and each other, and where possible, please seek joy and fun and connection. I believe these are the salves to stress and exhaustion.

Next year the College will continue to work towards a better health system and future, for all, and I encourage you to join in where you can.
Dr Stephen Gourley
ACEM President