A review of published literature on emergency medicine training programs in low- and middle-income countries

Abstract

BackgroundThe objective of this review is to identify and critically evaluate the published literature on emergency medicine (EM) training programs in resource-limited health-care settings in order to provide insight for developing EM training programs in such health systems.MethodsA literature search was conducted up to the end of April 2011 using MEDLINE, EMBASE, The Cochrane Library, EBM Reviews, Healthstar and Web of Science databases, using the following search terms: Emergency Medicine, Emergency Medicine Services, Education Training Residency Programs, Emergency Medical Systems and Medical Education, without limitation to income countries as outlined in the World Bank World Trade Indicators classification 2009-2010 (World Trade Indicators Country Classification by Region and Income, July 2009-July 2010). As the intent of the review was to identify and critically evaluate the literature readily available (published) to LMICs developing EM programs, the gray literature was not searched.ResultsThe search yielded 16 articles that met the final inclusion criteria. As the majority of articles provide a narrative description of the processes and building blocks used in developing the residency programs reported, we present our results in narrative format. By providing a summary of the lessons learned to date, we hope to provide a useful starting point for other resource-limited settings interested in establishing emergency medicine specialty training programs and hope to encourage further information exchange on this matter.ConclusionsThe results of the review indicate that EM training is in its infancy in resource-constrained health-care systems. There are few detailed reports of these programs successes and limitations, including efforts to optimize graduate retention. Despite the paucity of currently published data on the development of EM residency training programs in these settings, this review demonstrates the need for encouraging further information exchange to aid in such efforts, and the authors make specific recommendations to help guide future authors on reporting on such efforts.

Point‐of‐care ultrasound education for non‐physician clinicians in a resource‐limited emergency department

“…Currently in Africa, training programmes in emergency care exist but are sparse and focus mainly on physician education . However, physicians are an extremely limited resource in Africa, with a projected shortage of 800 000 physicians over 31 sub‐Saharan African countries by 2015 .…”

Emergency medicine in Zanzibar: the effect of system changes in the emergency department

“…Fatigue and resignation due to a high number of self-referred patients characterized the staff before the project started. This bypass of primary health care is described in other African and European countries [ 6 ]. The first step was to introduce regular staff meetings, and this simple change enabled the staff to express their frustrations.…”

Challenges in Emergency Medical Services in a ResourceLimited Setting in Sub-Sahara Africa; Perspectives from Cameroon: a Review Article

“…Lack of emergency medicine specialization program in most countries: Cameroon as of now has 7 medical schools with one offering various residency programs. As of august 2017, there is no residency program for the training of emergency medical physicians in Cameroon (11,32) . 7.…”

“…These physicians lit the flame of the modern specialty of emergency medicine so that the world could benefit from its light (10) . While attempts to provide emergency care are arguably as old as medicine, emergency medicine is relatively a young specialty about fifty years old having been officially recognized in both Europe and USA only in the latter half of the twentieth century (9,11) . The modern history of emergency medicine essentially began in the early 1960s.…”