Developing EM • LITFL • Postcards from the Edge

aka Postcards from the Edge 015

Lee Fineberg and Mark Newcombe are Emergency Physicians and Helicopter-Retrieval specialists who are better know in international EM circles for putting together a very successful conference on developing Emergency Medicine globally in Sydney last year. Their conference is called DevelopingEM and on Twitter they are @developingem. This ‘postcard from the edge’ is an interview with them about the DevelopingEM project.

What was the vision behind the Developing EM conference and what inspired you to host the inaugural sessions last year?

Mark:

Thanks Bish for the interview. There were a number of inspirations for DevelopingEM.
First and foremost was the desire to provide a conference experience that was different and inspirational for everyday clinicians. I think both of us have always wanted to in some way continue a meaningful interaction with global health and DevelopingEM 2012 was a way for us to introduce this concept.
However, the DevelopingEM 2013 conference in Cuba will allow our ultimate aim to come to fruition, through providing a clinically relevant emergency and critical care educational experience in an interesting destination, at the same time as interacting with and supporting local systems. We plan to do this through sponsoring local delegate attendance, provide educational hardware to the region, sponsor regional workshops, and foster ongoing interactions between physicians in the region and our delegates and faculty.

Lee:

Mark pretty much summed it up, but I’d also add that a strong part of our goal is to expand the boundaries of EM by bringing it to regions where it’s not yet practiced as a specialty. EM is well positioned to provide initiatives for global health improvement and we hope that by bringing our specialist faculty and conference delegates to these regions they will have the opportunity to meet colleagues from these regions, maintain connections, and hopefully even work in these regions in the future.
With the explosion of FOAMed on the scene, I don’t think there could be a better time to include all the regions of the world in the charge towards the best available Med-Ed and training. As Mark mentioned we don’t see ourselves as just another conference organization as we like to be part of the solution for local problems. Given limitations to internet access that may exist, we hope to use our conferences as a means to set-up computer/e-work stations in medical centers within developing regions. We’ve partnered with some amazing educators to provide both a curriculum for EM training as well as hard drive access to literally thousands of video & audio lectures. We’ll also be using proceeds from registration, non-industry sponsorship and donations to fund and maintain these e-work stations as well as subscriptions to various online journals & websites. And of course we’ll be sure to include direct links to the best of FOAMed!

Can you share some of the highlights from the first conference in Sydney last year?

Lee:

Without a doubt it was the general buzz that folks had for what we’re trying to do. More than just your typical conference lectures, people were seriously enthusiastic about being there and about involvement in future events. Whereas delegates at most conferences cant wait to find the door, we had several people offer their heartfelt thanks to us not to mention their promises to assist us with future projects. In fact, on hearing of our mission statement at the conference commencement one of our delegates who had lived and worked in Havana, Dr. Jeannie Ellis, got on the phone straight away to the Australian ambassador for Cuba. By the end of the first day we were arranging to meet with the Cuban Ambassador, Mr. Pedro Monzon to discuss DevelopingEM – Havana. And before we knew it we were well on our way. And the honest pledge of help from everywhere just keeps coming. If you take a look at our faculty – all of whom are self-funding – you’ll get an idea of what I mean. We’ve got some fantastic people share our interests and who’ve joined us for Sydney, Havana and beyond.

Mark:

I think the most amazing thing for me was that everything actually worked out without a hitch. People registered, presenters showed up at the right time on the right day, there were no AV malfunctions and despite the access to an open bar no one fell in the harbour during our dinner cruise!
We also got some amazing feedback on some amazing presentations which was pretty incredible in itself, and in general people seemed to get our concept and appreciate our efforts. Having a week off afterwards was also a particular highlight.

Cuba developing EM — The first Developing EM conference featured IEM legends like Peter Cameron

The Wilderness Rescue workshop at the first Developing EM conference in Sydney.

What is the reason behind Cuba as a venue for the upcoming conference and what have you got installed? Who is the event for, and why do you think they should put this one in their calendars now?

Mark:

Cuba was Lee’s idea but what an idea! Both being ‘pinko socialists’ we’d had an admiration for the Cuban health system for some time, and our more recent visits to Cuba solidified our interest in the country and it’s people.
Not only is it an amazing setting for a conference, but I think we can learn a great deal from the Cuban health system.
As far as the program goes it’s a mix of evidenced-based, clinically relevant presentations that were so popular last time, as well as presentations on IT, Simulation, Politics, and Global Health. We’ll also have workshops on Simulation and Ultrasound to be held in conjunction with the plenary in Havana, and let’s not forget a great social program and plenty of opportunities to meet our Cuban and Caribbean medico colleagues.

Lee:

As an American should I be “taking the fifth” on this? Or at least get some sort of legal advice??? Nah.
Many might say that given the quality and extent of Cuban health care – both domestically and internationally – that Cuba certainly doesn’t satisfy the area of need designation. In fact Cuba may very well serve as a model of health care delivery and global health outreach. For me the reason for bringing our conference to Havana was twofold;-
Firstly I wanted our delegates to see just how much can be done with limited resources. Cuba’s economy and GDP is a small fraction of ours and yet they have more government-sponsored doctors working abroad then all of G8 countries combined. At last count Cuba has 30,000 are health personnel workers in international collaborations in 103 different countries, 19,000 of whom are physicians! Mark and I recently returned from a meducational trip to Vanuatu and there were no fewer than 5 Cuban docs were working there on 2-4 year contracts arranged for them by the Cuban government. Profiling Cuba and their work was one of the main reasons for having the DevelopingEM conference in Havana, to show our delegates what can be done with limited resources if tried.
Another reason was the US embargo against Cuba. Politics aside, I think that the ongoing issue is a humanitarian disaster and an embarrassment to the developed nations of the world. I think that as docs we have an obligation to support the people of Cuba especially with respect to their health. I hope that by bringing our conference to Cuba that our delegates and faculty might learn a bit more about this issue, how it affects the health and lives of the Cuban people, and how we might in some way help to improve the situation even if just a little.
By the way I should point out that a legitimate professional conference such as ours is one of only a handful of ways that US citizens are legally allowed to travel to Cuba. For more information please see the US State Depts website.

Photo by Jorge Royan (used with permission under CC license)

Organizing a conference like this probably takes a lot of collaboration both locally and overseas. Do you have requests for help with this conference with regards to teaching and training or other resources?

Mark:

You’re right Bish, this sort of endeavour takes a lot of planning. As Lee mentioned we’ve been lucky enough to have the assistance of Dr. Jeannie Ellis, the Cuban ambassador to Australia Mr. Pedro Monzon, and Pedro Veliz, one of the preeminent emergency physicians in Cuba. Without the assistance of these three DevelopingEM 2013 would likely not have even gotten off the ground. We’ve also had ongoing assistance from our past faculty as well as an expanding faculty whom are equally enthusiastic about our project and program.

Lee:

I can’t agree more, but I’d also like to add that one of our goals with developingEM is to extend the conference beyond just the plenary. In addition to the main conference in Havana, we’re also planning for our specialist faculty and delegates to provide workshops and courses throughout the Caribbean.
At present we’re planning an Ultrasound course not only in Havana but also for St. Lucia. We’ve been working with Dr. Lisa Charles, the CMO for their main hospital in Castries to arrange the course. The faculty for the St. Lucia Ultrasound workshop will be headed by Mike Stone and Matt Dawson from the Ultrasound Podcast (a fantastic FOAMed site for Ultrasound skills training, so check it out). In addition our own Dr. Ricardo Hamilton, Director of Trauma at Liverpool Hospital & a native Bahamian, is working on an ATLS course for the Bahamas. We also have on offer the possibility for a PALS or APLS course as well as a Radiology workshop on Interpretation of EM Imaging for the region.
So if anyone out there is keen to help us find a Caribbean home for one these courses or perhaps would like to suggest another then by all means let us know– we’re always interested in fresh ideas! And should one of our esteemed delegate colleagues be keen to help out as faculty for a course then also let us know. You can contact us at: developingEM at gmail.com or to me directly at slfineberg at gmail.com

Finally do you have any tips or practical advice for anyone planning to attend the Developing EM (Cuba) conference later this year?

Lee:

For our US peeps I think the first step is having the knowledge that you can legally go to Havana on a general visa. No special approval or visas are required.
What better way to visit Havana then in support of your Caribbean colleagues. In fact the first Mojito is on Mark ☺. It will undoubtedly be an amazing event and I’m certain that you won’t be disappointed.

Mark:

I guess I’ll speak to the Aussies out there. Cuba is a long way but it’s a destination unlike any other and it’s changing as we speak.

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