Emergency Medicine is the knowledge and skills required for the prevention, diagnosis, and management of acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of episodic undifferentiated physical and behavioural disorders; it further encompasses an understanding of the development of prehospital and in-hospital emergency medical systems and the skills necessary for this development.
Why Emergency Medicine
Dr Joe Lex
Clinical Professor of Emergency Medicine (retired)
Temple University School of Medicine
Godfather of the FOAM (Free Open Access to Meducation) movement
First and foremost, welcome to Emergency Medicine. I am biased, but I truly feel we are the most interesting 15 minutes of every other speciality. I am about 30 years removed from my residency in EM. When I trained, 90% of the attendings had trained in another speciality and they were not a 24-hour presence. On the night shift, they headed off to bed about 11 pm and reappeared to cosign charts at 6:30 am. You were on your own and it was a sign of weakness to wake them up for help. [...]
Emergency Medicine in Africa
Emergency Medicine Training in Kenya
Currently, the few available Emergency Departments (ED) in referral hospitals are generally staffed by clinical officers and recently graduated medical officers with minimal training in the care of acute, critical or traumatic conditions. These EDs have no or very limited specialist coverage. At the county hospital level, EDs are largely absent, and no formal means exist for triaging patients who arrive with potentially life-threatening medical and surgical conditions.
There is a need to improve emergency services in Kenya. Ultimately, Kenyan referral centres and county hospital emergency services should be led by residency-trained emergency providers. This process, however, will take time.
An intermediate solution, the aim of this program is to train medical officers to better manage the initial triage and stabilization of patients with a wide variety of medical, surgical, and traumatic conditions at all times of day and night, provide supervision and direction for Emergency Medical Services (EMS) systems, and to coordinate disaster and emergency response at the local and national level.
Emergency Services at the Aga Khan University Hospital, Nairobi (AKUH, N)
The Accident & Emergency (A&E) department at AKUH, N is currently mainly staffed by Senior House Officers (SHOs) who are medical officers with varied years of post-internship experience with or without a Diploma in Primary Emergency Care and rotating residents from the Departments of Medicine, Surgery and Family Medicine.
They all work under the supervision of an Emergency Physician on a shift system. Also rotating periodically in the A&E are Family Medicine Consultants.
The A&E department is the first point of entry for most of the patients coming to the hospital. The department provides initial assessment, treatment, and stabilization to on average 180-200 patients a day with a broad spectrum of illnesses and injuries, some of which may be life-threatening and require immediate attention. It also responds to cardiac arrests across the hospital as part of the hospital resuscitation system (Code Blue). Approximately 5% of patients seen in the A&E are admitted to the hospital daily, with a third of them to Critical Care.
The Emergency Medicine (EM) Training Program is an 18-month (Full Time) competency-based training program conducted at The Aga Khan University, Nairobi (AKUH, N). The training program is aimed to equip the trainee, at the completion of their study, with the theoretical knowledge, practical ability, and interpersonal skills for full time or independent Emergency Medicine practice and qualification to write the College of Emergency Medicine of South Africa Diploma in Primary Emergency Care (Dip PEC) examination.
This is an 18 months training program which culminates in qualification to take the South African College of Emergency Medicine Diploma in Primary Emergency Care (Dip PEC) examination.
Emergency medicine exams have been held through the South African Colleges of Medicine since 1986: the Diploma in Primary Emergency Care (Dip PEC) was initially offered by the College of Family Practitioners but transferred to the College of Emergency Medicine in 2004. The exam is intended for non-specialists already working in emergency care.
Other countries that also offer the Diploma in Emergency Medicine include Rwanda, Australia, the UK and now Kenya.
The course and examination details and the curriculum are available in the College of Medicine of South Africa website – CLICK HERE
The trainees work on a rotational basis in the following departments:
- Adult Accident & Emergency (A&E) – 9 months
- Paediatrics A&E – 3 months
- Intensive Care Unit (ICU) – 3 months
- Anaesthesia – 2 months
- Obstetrics & Gynaecology (OBGYN) – 1 month
Additional time is also spent working in the prehospital system.
Their duties are scheduled by the respective departmental heads in line with the 42-hours a week policy.
Currently, we have a full-time Emergency Physician and visiting international EM faculty teaching the programme. Being a University hospital, faculty from the other departments the trainees rotate through are also involved in their teaching and supervision to meet the rotational objectives in line with the program objectives. Visiting Emergency Medicine faculty are also welcome to participate in the teaching and training.
Designation and Compensation
Medical Officers enrolled in the program are designated as “Emergency Medicine Trainees.” In addition to training time, they are required to work a regular full-time position of 42 hours per week and may work up to an additional 20% time as desired and subject to performance and shift availability.
No tuition fees are charged. Examination fees and travel to South Africa for the diploma examination are at the trainee’s expense.
The program is only open to Medical Officers registered or registerable by the Kenya Medical Practitioners and Dentists Council
Applications are currently closed until April 2023