E1 - Global Emergency Medicine

Abstract

Global emergency medicine (GEM) is an academic subspecialty of emergency medicine focused on the strengthening of the specialty worldwide and on improving international humanitarian response. The model curriculum for a GEM fellowship includes experiences in emergency medicine systems, humanitarian relief, disaster medicine, public health, travel and field medicine, program administration, academic skills, and clinical skills. Broadly, GEM can be divided into development and humanitarian work. Development work is typically focused on sustainably strengthening local systems, while humanitarian work involves the acute response to large-scale crises in which local resources are overwhelmed. Training program sustainability in GEM is supported by identifying future educators and preparing them to take local ownership of the program and ensuring graduates are employable and able to practice within their scope. Educational opportunities should be bidirectional between institutions, ideally with exchange programs. There are distinctive ethical challenges in GEM research, including differences in access to standard care, vulnerable populations, power differentials, and consent quality. Disparity persists in first authorship between high-income countries (HIC) and low- and middle-income countries (LMIC), despite a substantial amount of GEM research taking place in LMICs. The responsible practice of GEM involves detailed attention to safety and security. Situations can change abruptly with little warning, and plans should be in place to cover possible events ranging from minor illness to a major regional crisis.