scholarly journals Emergency medicine in Brazil: historical perspective, current status, and future challenges

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Lucas Oliveira J. e Silva ◽  
Henrique Herpich ◽  
Henrique Alencastro Puls ◽  
Justin Guy Myers ◽  
Daniel Ujakow Correa Schubert ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Emergency Care ◽  
Historical Perspective ◽  
Medical Specialty ◽  
Current Status ◽  
Care Practice ◽  
Emergency Physicians ◽  
Residency Programs ◽  
Future Challenges ◽  
Formally Trained

Abstract Background Emergency medicine (EM) in Brazil has achieved critical steps toward its development in the last decades including its official recognition as a specialty in 2016. In this article, we worked in collaboration with the Brazilian Association of Emergency Medicine (ABRAMEDE) to describe three main aspects of EM in Brazil: (1) brief historical perspective; (2) current status; and (3) future challenges. Main text In Brazil, the first EM residency program was created in 1996. Only 20 years later, the specialty was officially recognized by national regulatory bodies. Prior to recognition, there were only 2 residency programs. Since then, 52 new programs were initiated. Brazil has now 54 residency programs in 16 of the 27 federative units. As of December 2020, 192 physicians have been board certified as emergency physicians in Brazil. The shortage of formal EM-trained physicians is still significant and at this point it is not feasible to have all Brazilian emergency care units and EDs staffed only with formally trained emergency physicians. Three future challenges were identified including the recognition of EM specialists in the house of Medicine, the need of creating a reliable training curriculum despite highly heterogeneous emergency care practice across the country, and the importance of fostering the development of academic EM as a way to build a strong research agenda and therefore increase the knowledge about the epidemiology and organization of emergency care. Conclusion Although EM in Brazil has accomplished key steps toward its development, there are several obstacles before it becomes a solid medical specialty. Its continuous development will depend on special attention to key challenges involving recognition, reliability, and research.

What and how are EM residents being taught to respond to the next disaster?

2018 ◽  
Vol 13 (4) ◽  
pp. 279-287 ◽  
Author(s):  
Angela P. Cornelius, MD ◽  
W. Knox Andress, BA, RN ◽  
Reuben Ajayi, MS ◽  
Urska Cvek, ScD, MBA ◽  
Brian Cornelius, DNP, CRNA ◽  
...  
Keyword(s):  
Journal Club ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Current Status ◽  
Emergency Physicians ◽  
Residency Programs ◽  
Disaster Education ◽  
Method Of Instruction ◽  
Curriculum Standardization ◽  
Computerized Survey

Objective: Disasters, both natural and manmade, have become commonplace and emergency physicians serve on the front line. Residency may be the only time that emergency physicians are exposed to a disaster, through training, until one happens in their department; therefore, it is critical to provide residents with appropriate and timely disaster education. The goal of this study was to assess the current status of disaster education in emergency medicine (EM) residencies in the United States.Methods: A list of disaster topics was generated by reviewing disaster literature and validated by subject matter experts. Between May and December 2016, the authors conducted a national computerized survey of the 229 US EM residencies listed by the American Osteopathic Association and the American Medical Association. It focused on the methods of instruction and amount of time devoted to each topic.Results: Of the 229 eligible residency programs, 183 (79.9 percent) completed the survey. Of those, 98.9 percent report teaching disaster management topics. Nine of 18 disaster medicine topics were taught at 60 percent of responding programs. The most common topics were emergency management principles and mass casualty triage, while the least common was hazard vulnerability analysis. The most common method of instruction was lecture (68.5 percent) and the least common methods were journal club and field exercises.Conclusions: Broad education in disaster medicine is provided in most US EM residencies. Standardization of topics is still lacking and would be beneficial to encourage comprehensive education. Addressing the educational gaps and curriculum methodology changes identified in this survey would increase curriculum standardization.

scholarly journals CAEP 2015 Academic Symposium: Recommendations for University Governance and Administration for Emergency Medicine

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S18-S25 ◽  
Author(s):  
David Petrie ◽  
Anil Chopra ◽  
Alecs Chochinov ◽  
Jennifer D. Artz ◽  
Michael Schull ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Good Governance ◽  
Local Environment ◽  
Essential Elements ◽  
Current Status ◽  
Emergency Physicians ◽  
Canadian Association ◽  
Academic Units ◽  
Research And Education ◽  
Exceptional Patient

AbstractObjective1) To identify the strengths and challenges of governance structures in academic emergency medicine (EM), and 2) to make recommendations on principles and approaches that may guide improvements.MethodsOver the course of 9 months, eight established EM leaders met by teleconference, reviewed the literature, and discussed their findings and experiences to arrive at recommendations on governance in academic units of EM. The results and recommendations were presented at the annual Canadian Association of Emergency Physicians (CAEP) Academic Symposium, where attendees provided feedback. The updated recommendations were subsequently distributed to the CAEP Academic Section for further input, and the final recommendations were decided by consensus.ResultsThe panel identified four governance areas of interest: 1) the elements of governance; 2) the relationships between emergency physicians and academic units of EM, and between the academic units of EM and faculty of medicine; 3) current status of governance in Canadian academic units of EM; and 4) essential elements of good governance. Six recommendations were developed around three themes, including 1) the importance of good governance; 2) the purposes of an academic unit of EM; and 3) essential elements for better governance for academic units of EM. Recommendations included identifying the importance of good governance, recognizing the need to adapt to the different models depending on the local environment; seeking full departmental status, provided it is mutually beneficial to EM and the faculty of medicine (and health authority); using a consultation service to learn from the experience of other academic units of EM; and establishing an annual forum for EM leaders.ConclusionAlthough governance of academic EM is complex, there are ways to iteratively improve the mission of academic units of EM: providing exceptional patient care through research and education. Although there is no one-size-fits-all guide, there are practical recommended steps for academic units of EM to consider.

scholarly journals Emergency medicine training in Canada

CJEM ◽  
1999 ◽  
Vol 1 (01) ◽  
pp. 51-53 ◽  
Author(s):  
Kieran Moore ◽  
Cindy-Ann Lucky
Keyword(s):  
Emergency Medicine ◽  
Training Program ◽  
Emergency Care ◽  
Critical Mass ◽  
Rural Practice ◽  
Emergency Physicians ◽  
Certification Process

SUMMARY: Canada is the only country with two colleges governing emergency medicine (EM) certification. Does this serve us well or does it divide us and our resources? If most CCFP(EM) graduates practise strictly EM, with no family or rural practice, then reform in the certification process may be necessary. At the same time, FRCPC residencies seem excessively long and lack the numbers to develop “critical mass.” Shortening the length of training would allow more residency positions to be created, thus advancing the goal of optimum emergency care for the Canadian public. Canadians deserve one standardized, certified, accredited EM training program that produces the highest quality emergency physicians.

scholarly journals Point-of-Care Ultrasound Training and Credentialing for mid-late Career Emergency Physicians: Is it worth it?

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 56-57
Author(s):  
Courtney Smalley ◽  
Erin Simon ◽  
McKinsey Muir ◽  
Fernando Delgado ◽  
Baruch Fertel
Keyword(s):  
United States ◽  
Emergency Medicine ◽  
Quality Assurance ◽  
American Medical Association ◽  
Medical Association ◽  
Emergency Physician ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Emergency Physicians ◽  
Residency Programs

Point-of-care ultrasound (POCUS) is becoming more prevalent in community emergency medicine (EM) practice with the current American College of Emergency Physician guidelines recommending POCUS training for all graduates from United States based residency programs as well as support for POCUS privileging by the American Medical Association. However, in a recent survey of nonacademic EDs, it was found that most providers lack US training, credentialing, and quality assurance (QA) assessments of their POCUS studies. In 2017, our healthcare system embarked on a system-wide credentialing process for POCUS to credential community physicians with little to no POCUS training.

scholarly journals Professionalism Milestones Assessments Used by Emergency Medicine Residency Programs: A Cross-sectional Survey

2019 ◽  
Vol 21 (1) ◽  
pp. 152-159 ◽  
Author(s):  
Christine Stehman ◽  
Steven Hochman ◽  
Madonna Fernández-Frackelton ◽  
Emilio Volz ◽  
Rui Domingues ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Technical Skills ◽  
Summative Evaluation ◽  
Emergency Physicians ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Residency Programs ◽  
Quality Patient Care ◽  
Vital Component ◽  
Clinical Competency Committee

Introduction: Professionalism is a vital component of quality patient care. While competency in professionalism is Accreditation Council for Graduate Medical Education (ACGME)-mandated, the methods used to evaluate professionalism are not standardized, calling into question the validity of reported measurements. We aimed to determine the type and frequency of methods used by United States (US) -based emergency medicine (EM) residencies to assess accountability (Acc) and professional values (PV), as well as how often graduating residents achieve competency in these areas. Methods: We created a cross-sectional survey exploring assessment and perceived competency in Acc and PV, and then modified the survey for content and clarity through feedback from emergency physicians not involved in the study. The final survey was sent to the clinical competency committee (CCC) chair or program director (PD) of the 185 US-based ACGME-accredited EM residencies. We summarized results using descriptive statistics and Fisher’s exact testing. Results: A total of 121 programs (65.4%) completed the survey. The most frequently used methods of assessment were faculty shift evaluation (89.7%), CCC opinion (86.8%), and faculty summative evaluation (76.4%). Overall, 37% and 42% of residency programs stated that nearly all (greater than 95%) of their graduating residents achieve mastery of Acc and PV non-technical skills, respectively. Only 11.2% of respondents felt their programs were very effective at determining mastery of non-technical skills. Conclusion: EM residency programs relied heavily on faculty shift evaluations and summative opinions to determine resident competency in professionalism, with feedback from peers, administrators, and other staff less frequently incorporated. Few residency programs felt their current methods of evaluating professionalism were very effective.

scholarly journals Stroke Education in Canadian Emergency Medicine Residency Programs

CJEM ◽  
2015 ◽  
Vol 18 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Devin R. Harris ◽  
Philip Teal ◽  
Matthew Turton ◽  
Brian Lahiffe ◽  
Simon Pulfrey
Keyword(s):  
Emergency Medicine ◽  
Emergency Physicians ◽  
Team Leaders ◽  
Residency Programs ◽  
Stroke Team ◽  
Life Threatening ◽  
English Speaking ◽  
Ischemic Attack ◽  
Training Opportunities ◽  
Lecture Time

AbstractObjectivesStroke and transient ischemic attack (TIA) are common disorders treated by Canadian emergency physicians. The diagnosis and management of these conditions is time-sensitive and complex, requiring that emergency physicians have adequate training. This study sought to determine the extent of stroke and TIA training in Canadian emergency medicine residency programs.MethodsA two-page survey was emailed to directors of all English-speaking emergency medicine residency programs in Canada. This included both the Fellow of the Royal College of Physicians of Canada (FRCPC) and the College of Family Physicians Enhanced Training [CCFP(EM)] residency programs. The number of mandatory and elective rotations, lectures, and examinations relevant to stroke and TIA were assessed.ResultsNine FRCPC programs responded (of 11; RR=82%) and 11 CCFP(EM) programs responded (of 18; RR=61%), representing 20 of 29 programs in Canada (RR: 20/29=69%). Mandatory general neurology (3/9) and stroke neurology (2/9) rotations were offered in a minority of FRCPC programs and not at all in CCFP(EM) programs (0/11). Neuroradiology rotations were mandatory in 1/9 FRCPC programs and no CCFP(EM) programs (0/11). Acute ischemic stroke was allocated 3 hours of lecture time per year in all residency programs, regardless of route of training. Despite the fact that 100% of respondents train residents in facilities that administer thrombolysis for stroke, only 1/11 (9%) CCFP(EM) programs and 0/9 FRCPC programs have residents act as stroke team leaders.ConclusionsFormal training in stroke and TIA is limited in Canadian emergency medicine residency programs. Enhanced training opportunities should be developed as this disease is sudden, life-threatening, and can have disabling or fatal consequences, and therapeutic options are time sensitive.

Current Status of International Emergency Medicine Fellowships in the United States

2005 ◽  
Vol 20 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Gregory H. Bledsoe ◽  
Chayan C. Dey ◽  
Christopher Kabrhel ◽  
Michael J. VanRooyen
Keyword(s):  
Public Health ◽  
United States ◽  
Emergency Medicine ◽  
International Health ◽  
The United States ◽  
Current Status ◽  
Emergency Physicians ◽  
International Emergency Medicine ◽  
Public Health Training ◽  
International Projects

AbstractObjective:A consensus panel of Emergency Physicians with experience in international health has published a recommended curriculum for a formal fellowship in International Emergency Medicine. This article reviews the current International Emergency Medicine (IEM) fellowships available to residency-trained Emergency Physicians in the United States.Methods:Every allopathic Emergency Medicine (EM) residency program in the United States was contacted via e-mail or telephone. Programs that reported having an IEM fellowship were asked detailed information about their program, including: (1) the number of years the program has been offered; (2) the duration of the program; (3) the number of fellows taken each year; (4) the number of fellowship graduates from each program and their current practice patterns; (5) how the fellowship is funded; and (6) whether a Masters Degree in Public Health (MPH) is offered.Results:All 127 allopathic EM residency programs responded. Eight (6.8%) of these programs offered IEM fellowships. Of a total of 29 graduates identified, 23 (79.3%) were employed in academic medicine. All of the fellowships offered formal public health training and were funded by a combination of clinical billing and project-specific grants and scholarships. All IEM fellowships described a curriculum that reflected the previously published recommendations.Conclusion:Opportunities in formal training in international health are increasing for graduates of EM residencies in the United States. The proposed curriculum for IEM fellowships seems to have been implemented and graduates of IEM fellowships seem to be applying their training in international projects.

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