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Emergency medical care in Pakistan has not been a priority of medical education and training because of the country's need to address its lack of primary care. Resources and trained personnel are scarce. Despite these challenges, the value of emergency medical care is gaining attention. The objective of this study was to explore the breadth of Emergency Medicine training in Pakistan through an analysis of an Emergency Medicine residency in a teaching hospital. The Aga Khan University Hospital in Karachi is a teaching institution with the only Emergency Medicine residency program in the region. It was started in 2000, led by US-trained physicians, and it laid the foundation for Emergency Medicine in the country.
Methods
The study was conducted over a four-week period in January of 2009. Data collection consisted of three components: (1) a survey of the Emergency Department and hospital services; (2) a survey of the Emergency Medicine training curriculum; and (3) a retrospective chart review of every tenth patient seen in the Aga Khan Emergency Department from December 1-14, 2008.
Results
The training program is similar to that of the US models. Of the 153 patients selected for the chart review, the majority presented with GI complaints. Of these, 51 (33%) were admitted to the hospital; 20% (n = 15) left against medical advice; the remaining 57% (n = 87) were discharged.
Discussion/Conclusion
The hospital admitted patients with complaints that were expected in the region. Although Aga Khan University Hospital is a pioneer in establishing Emergency Medicine as an official medical discipline in the region, the hospital's obstetrics and gynecology, trauma, toxicology and prehospital services training do not meet current curriculum standards set forth by the Society of Academic Emergency Medicine and the Council of Emergency Medicine Residency Directors. Nevertheless, the review provides a snapshot of the development of Emergency Medical Services in a developing nation. This information may assist other nations that are interested in developing such programs.
LinJY, AhmedS, BranderC. Breadth of Emergency Medical Training in Pakistan. Prehosp Disaster Med. 2013;28(2):1-5.
Traditionally, emergency care in Pakistan has not been a priority because of lacking primary care. Resources and trained personnel are scarce. Cultural barriers often supersede the urgency of medical conditions. Despite these challenges, the value of emergency care is gaining significance. The objective of this study is to explore the breadth of emergency medicine training in Pakistan, through an analysis of a teaching hospital with an emergency medicine residency. Aga Khan University Hospital in Karachi is a teaching institution with the only emergency medicine residency program in the region. It was started in 2000, led by US-trained physicians, and laid the foundation for emergency medicine in the country.
Methods:
A review and analysis of the curriculum and clinical duties will be conducted to illustrate the specific roles and training of emergency medicine physicians. A chart review of patients seen in the emergency department during a two-week period will be conducted to determine if the current training is appropriate for the patient population and diseases seen.
Results:
This study will provide a view of a curriculum in development and report on unique aspects of the program in relation to other established emergency medicine programs throughout the world. Furthermore, different roles emergency medicine physicians may play in this particular hospital setting will be identified.
Conclusions:
Aga Khan University Hospital is a pioneer in establishing emergency medicine as an official discipline in the region. Through an examination of how a program is developing in Pakistan, an invaluable look of how emergency medical care is gaining significance in developing nations will be provided. This will help other nations that are interested in developing such programs to do so.
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