Emergency medicine residency training in Africa: overview of curriculum

Hendry R Sawe,Erin Noste,Juma A Mfinanga,Abena Akomeah,Michael S Runyon

doi:10.1186/s12909-019-1729-1

Abstract

BackgroundEmergency Medicine (EM) is a rapidly developing specialty in Africa with several emergency medicine residency-training programs (EMRPs) established across the continent over the past decade. Despite rapid proliferation of the specialty, little is known about emergency care curriculum structure and content. We provide an overview of Africa’s EMRPs.MethodsThis was a descriptive cross-sectional survey conducted of EMRPs in Africa between January 2017 and December 2017. Data were prospectively collected using a structured survey that was developed and administered through online data capture software, REDCap (Version 7.2.2, Vanderbilt, Nashville, TN, USA). Survey questions focused on curriculum structure and design, including clinical rotations, didactics, research, and evaluation. Data are summarized with descriptive statistics.ResultsThe survey was sent to the leadership of 15 EMRPs in 12 different African countries and 11 (73%) responded. Five (46%) of the responding programs were started by local non-EM trained faculty, two (18%) were started by international partners, and the remainder by a combination of local non-EM faculty and international partners. Overall, Seven (64%) of the countries offer a 4-year EMRP. In General, 40% of curriculums are influenced the contents developed by African Federation for Emergency Medicine. All programs offer resident led-didactics, with a median of 12 h (Interquartile range 9–6 h) per month. All EMRPs have a mandatory research requirement. All EMRPs offer clinical rotations in the ED, Paediatrics, and Obstetrics and Gynaecology, while only 2 programs offer rotations in radiology and neonatal intensive care units. Only 46% of EMRPs have in-ED clinical supervision by specialist.ConclusionThe EMRPs in Africa were started by non-EM trained local faculty alone or collaboration with international partners. The curriculum offers most exposure to ED, and less exposure in radiology and neonatal intensive care. Residents are highly involved in leading didactics and less than half of the programs have in-ED specialist supervision of patient care.

Highlights

Emergency Medicine (EM) is a rapidly developing specialty in Africa with several emergency medicine residency-training programs (EMRPs) established across the continent over the past decade
During the study period there were 15 African EMRPs for physicians identified across 12 different countries
Of the 10 programs providing the details of their curricula, 6 (60%) review their curriculum anywhere from annually to every 5 years, while 4 (40%) have no specific timing for reviewing their curriculum (South Africa, Botswana, Malawi and Tanzania). 60% curricula are influenced by local and international professional organisations: 4/10 by African Federation for Emergency Medicine (AFEM), 10% Society for Academic Emergency Medicine (SAEM) and 10% by local professional organisation (LPO) Fig. 2

Summary

Introduction

Emergency Medicine (EM) is a rapidly developing specialty in Africa with several emergency medicine residency-training programs (EMRPs) established across the continent over the past decade. We provide an overview of Africa’s EMRPs. Emergency Medicine (EM) is a rapidly evolving specialty in Africa, despite being a relatively new concept in many countries [1]. Specialty training in EM is an essential component of high-quality emergency care systems in any country. As of 2017 there were at least twelve African countries with emergency medicine residency programs (EMRPs) These countries started their EMRPs at different times, with South Africa the first to launch a dedicated emergency medicine specialist-training program in 2004 [9]. The formation of the African Federation for Emergency Medicine (AFEM) in 2009 provided an opportunity for professional linkages and exchange of scientific content and expertise among the different training programs across Africa [10]

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