Emergency Medicine Training Opportunities Around the World

(This article was originally published in 2012 in issue 8 of Emergency Physicians International)

by Terrence Mulligan, DO, MPH

Full EM Residency Abroad

Obtaining full EM specialty training in another country offers the works, from qualified supervision to system exposure to interaction with senior faculty and mentors. The hurdles are many: funding, years of testing (USMLE 1-2-3), multi-year commitment and language. Plus, the foreign residency track also increases “brain drain.” Many residencies exist, but are focused in places where EM has been around the longest (USA, Canada, UK, Ireland, Australia,New Zealand, Hong Kong, Singapore).

Observational Fellowships

Foreign medical graduates have the option of obtaining partial EM specialty or subspecialty training in host country through observerships. These pogroms, which accept applicants as visiting fellows rather than official residents, cover a range of topics (exposure level varies). Program lengths vary from weeks to years. Typically, observerships are shorter than residencies, and can be offered to multiple faculty members from same foreign program at once. They are less expensive than full residencies, but rarely offer practice rights or specialty status upon completion. Observerships can be expensive, and most programs are located within EM residencies that have International EM departments.

Foreign Consultants

One option for global education is for an EP to simply move to a host country and learn through working in the field. The time frame for these stints can range from weeks to years. While “outsider” status can be a benefit in these scenarios – helping overcome certain barriers to development – it can also be a burden. As can be language barriers and differences in training. Countries like the Netherlands and South Africa are known to host foreign consultants.

Educational Courses

Trained EM faculty travel to foreign countries for short, focused courses on specific areas of emergency medicine. Alternatively, EM faculty can travel to a host country to obtain focused training as a team. This can be an economical option for advanced training, and can help jump start larger programs. Downside: short courses are limited in scope and can convey a false sense of competency. Certain aspects of EM simply cannot be taught in a shortened format.

Conferences

A good way to get exposure to global emergency medicine is to attend a national, regional or global conference. Given the number of countries with EM as a recognized specialty, there is an EM meeting somewhere in the world nearly every month. While these meetings are great for networking, and are often where policy decisions get made, their educational impact is questionable. Like short courses, they can give a false sense of competency. In addition, conferences can be subject to local politics, and can be expensive.

Publications

When not attending a course or conference, a great way to stay up to date is with an emergency medicine publication. More than 15 national and regional journals are published, providing up-to-date, peer-reviewed content tailored to the emergency medicine audience. While these publications gain in impact each year, they have the difficulty of being region-specific, and access can be cost-prohibitive. To find a journal, start by contacting the EM society of your choice; many will have either a journal or a dedicated international section.

On-line Resources

Every day, more EM educational, testing and instructional material are being made available on-line, some even for free. The material is available instantly, usually at a low cost, covering a wide range of topics. However, content is often disorganized, and it can be difficult to gauge credibility. Many EM societies have begun collaborating on online educational materials, so look for more in this arena in coming months and years.