aka Postcards from the Edge 009
This ‘Postcard from the Edge’ highlights a talk given by Dr Chris Curry at ACEM2011 conference in Sydney. Chris discusses the development of emergency medicine training in LDCs (Least Developed Countries), using the examples of Papua-New Guinea and Nepal, and takes a look west to Botswana and Africa.
The need for capacity to respond to acute illness and injury is greatest in least developed countries (LDCs), where resources are extremely limited and infrastructure for the delivery of health care is fragile.
The development of specialisation is following the developed world, with the traditional leaders of surgery and internal medicine dominant. The younger specialties of the developed world are only just being considered in some of the 48 LDCs, and emergency medicine (EM) is one of these.
The building of EM needs to be shaped to the peculiarities of the environment. Postgraduate medical training is managed variously. In PNG the Postgraduate Committee of the School of Medicine and Health Sciences in the University of PNG has control of all postgraduate training. In Nepal several institutions are involved in postgraduate training, with differences between them. While an EM curriculum can have a shared foundation, such as that promulgated by the IFEM, local variations and areas of emphasis are important. The pathway by which a trainee can be exposed to learning is dependent upon services available and local ways of managing training and service. An initial absence of EM trained faculty requires resourcefulness from local trainers, who can benefit from the input of EPs who have experience of the beginnings of development elsewhere.
The particulars of resources, infrastructure, and position of EM within the totality of health care delivery, have a profound impact on the delivery of training and have to be considered in determining levels of performance for a new specialist. These factors impinge on assessment and examination.
An EP contributing from a more developed EM system may have more to learn than to teach.
The slides for the talk are shown below. The slides are best viewed on slideshare.net so you can view the speaker notes as you flick from slide to slide (click on the ‘Speaker Notes on Slide x’ tab under the slideshow).
from the edge