Formal training in pediatric emergency medicine: The surgeon's contribution

Abstract

The emergency department offers an unparalleled arena in which to teach, to carry out clinical research, and to influence the quality of patient care. In the United States, 31 formal programs have been established to prepare physicians for careers in adult emergency medicine. Until recently, no university medical center provided a formal training program in the emergency medicine of childhood. The first such program was launched in July 1977 in a large children's hospital with 57,000 emergency department visits per year. The objective is to prepare Board-eligible pediatricians to assume full-time supervisory positions in emergency departments in children's hosptials or large teaching general hospitals. The trainees enter the program with less experience in dealing with surgical emergencies than with pediatric medical emergencies. For this reason the teaching contributions of general pediatric surgery and the pediatric surgical specialties of orthopedics, neurosurgery, anesthesia, thoracic surgery, urology, plastic surgery, and otolaryngology are especially important. These are coordinated by the author. A review of the first 9 mo suggests that the conflicting needs of the emergency medicine fellows and those of other trainees in pediatric medicine and the pediatric surgical specialties are easily resolved. Improvement in patient care and teaching in the emergency department has been documented, and a start has been made toward developing a research program in the emergency problems of children. The emergency department offers an unparalleled arena in which to teach, to carry out clinical research, and to influence the quality of patient care. In the United States, 31 formal programs have been established to prepare physicians for careers in adult emergency medicine. Until recently, no university medical center provided a formal training program in the emergency medicine of childhood. The first such program was launched in July 1977 in a large children's hospital with 57,000 emergency department visits per year. The objective is to prepare Board-eligible pediatricians to assume full-time supervisory positions in emergency departments in children's hosptials or large teaching general hospitals. The trainees enter the program with less experience in dealing with surgical emergencies than with pediatric medical emergencies. For this reason the teaching contributions of general pediatric surgery and the pediatric surgical specialties of orthopedics, neurosurgery, anesthesia, thoracic surgery, urology, plastic surgery, and otolaryngology are especially important. These are coordinated by the author. A review of the first 9 mo suggests that the conflicting needs of the emergency medicine fellows and those of other trainees in pediatric medicine and the pediatric surgical specialties are easily resolved. Improvement in patient care and teaching in the emergency department has been documented, and a start has been made toward developing a research program in the emergency problems of children.