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.
Highlights
The 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
While much can be learned from partners from mature EM system, as these are predominantly from High-income countries (HICs) they may not have much in common with low- and middle-income countries (LMICs) health systems
We encourage developing EM training programs in LMICs to continue reporting on their efforts, whether successful or not, in order to help gain further understanding of the facilitators and roadblocks to such efforts
Summary
The 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. Emergency medicine (EM) is a relatively new specialty around the world, having been officially recognized in both Europe and North America only in the latter half of the twentieth century. To this day, emergency departments (EDs) in many countries are not staffed with specialists with specific training in the discipline, but rather patients and constrained or underdeveloped EM systems. As part of an effort to combat this, in 2010 Addis Ababa University initiated the first emergency medicine residency training program at Tikur Anbessa Hospital. As part of a group of emergency medicine physicians and residents at the University of Toronto, we have been collaborating in the above-mentioned endeavor
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