Video – Panel Discussion – EM Education in Asia

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – International Emergency Medicine Education Project

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – Road Forwards in Emergency Medicine Education

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – Educator in Emergency Medicine

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – Challenges in Emergency Medicine Education

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – EM Education Across Asia – EM Residents

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Video – EM Education in India – Medical Students

This blog post includes one of the presentations of Emergency Medicine Education in Asia Webinar organized by Asian Society for Emergency Medicine on July 9, 2022. 

Emergency Medicine Perspectives of Students – North America

Dear EM family,

The International Emergency Medicine Education Project (iem-student.org) has completed three years. As you may know, the iEM Education project aims to promote Emergency Medicine and provides copyright-free resources to students and educators around the world. Now we have reached more than 200 countries. We would like to thank again our contributors. Without them, such a project would not be possible. This experience has shown us once again how passionate our international EM community is to help and teach each other.

In May 2021, we started the fourth year of this journey. To celebrate, we are pleased to announce alive activity series, Emergency Medicine Perspectives of Students Around the World. Our guests for the third session are Kayla M. Ferguson, Brenda M. Varriano, and Dr. Halley J. Alberts.

Together, we can understand the experiences and needs of medical students from different backgrounds and discuss potential solutions.

Here are the video and audio records of this session. 

Cite this article as: Arif Alper Cevik, "Emergency Medicine Perspectives of Students – North America," in International Emergency Medicine Education Project, May 23, 2022, https://iem-student.org/2022/05/23/emergency-medicine-perspectives-of-students-north-america/, date accessed: October 2, 2022

Emergency Medicine Perspectives of Students – Central and South America

Dear EM family,

The International Emergency Medicine Education Project (iem-student.org) has completed three years. As you may know, the iEM Education project aims to promote Emergency Medicine and provides copyright-free resources to students and educators around the world. Now we have reached more than 200 countries. We would like to thank again our contributors. Without them, such a project would not be possible. This experience has shown us once again how passionate our international EM community is to help and teach each other.

In May 2021, we started the fourth year of this journey. To celebrate, we are pleased to announce alive activity series, Emergency Medicine Perspectives of Students Around the World. Our guests for the third session are Henrique Herpich from Brazil, Genesis Soto Chaves from Costa Rica, and William Gopar Franco from Mexico..

Together, we can understand the experiences and needs of medical students from different backgrounds and discuss potential solutions.

Here are the video and audio records of this session. 

Cite this article as: Arif Alper Cevik, "Emergency Medicine Perspectives of Students – Central and South America," in International Emergency Medicine Education Project, May 16, 2022, https://iem-student.org/2022/05/16/emergency-medicine-perspectives-of-students-central-and-south-america/, date accessed: October 2, 2022

Emergency Medicine Perspectives of Students – Asia

Dear EM family,

The International Emergency Medicine Education Project (iem-student.org) has completed three years. As you may know, the iEM Education project aims to promote Emergency Medicine and provides copyright-free resources to students and educators around the world. Now we have reached more than 200 countries. We would like to thank again our contributors. Without them, such a project would not be possible. This experience has shown us once again how passionate our international EM community is to help and teach each other.

In May 2021, we started the fourth year of this journey. To celebrate, we are pleased to announce alive activity series, Emergency Medicine Perspectives of Students Around the World. Our guests for the third session are Nanditha S. Vinod from India, Kezban Sila Kunt from Turkey, and Nanette B. Doroja from Phillipines.

Together, we can understand the experiences and needs of medical students from different backgrounds and discuss potential solutions.

Here are the video and audio records of this session. 

Part 1

Part 2

Cite this article as: Arif Alper Cevik, "Emergency Medicine Perspectives of Students – Asia," in International Emergency Medicine Education Project, May 9, 2022, https://iem-student.org/2022/05/09/emergency-medicine-perspectives-of-students-asia/, date accessed: October 2, 2022

Journal Club 11/29/21: Ethics of Humanitarian Work

POCUS in Resource-Limited Settings presented by Holly A. Farkosh

POCUS, or point-of-care ultrasound, is a focused exam performed and interpreted by an examiner usually at the bedside, that must answer a specific question (is there a pleural effusion, yes or no?). The diagnosis must also be 1) relevant to consecutive treatment decision-making and 2) easily and accurately recognizable by the physician applying the US without extensive training.

There are many advantages to using POCUS in a resource-limited setting, including but not limited to: 

– Portability; relatively inexpensive starting at $2000

– Limited access to other diagnostic imaging equipment (XR, CT, MRI–all of which require additional training to read and use/operate)

– Rapid, noninvasive

– No ionizing radiation exposure

– Improves success and safety of bedside procedures

– Can easily be repeated, quickly, and without increasing radiation exposure, especially if clinical status or physical exam findings change 

– Particularly cost-effective (in the United States) in pediatric appendicitis and trauma (found to have decreased time to OR, decreased CT scans in the pediatric population, shortened length of hospital stay)

Some of the disadvantages include:

– Requirement of formal training

– Issue of how to power/charge and reliable access to this

– Handheld US requires a smartphone

– Supplies (US gel)

– Upkeep and repair

– Image portability (inability to print or save images for patients to share with other healthcare providers)

– Ethical considerations? 

Tying it all Together: Ethical Considerations for POCUS in Resource-Limited Settings

– Cost-effectiveness: some resources are deemed too expensive

– Resource limitations and differences in standard of care between the United States and other countries 

– Practitioners who may be teaching US may have limited knowledge of practicing in resource-limited settings, or there may be discrepancies in both knowledge of using the technology/resources available as well as the common presenting diseases in that region

– Sustainability: in relation to implementing training programs– what happens after instructors leave? Requires adequate planning for system integration and ongoing supervision and skill maintenance

– Limited capacity and inconsistent availability of follow-up care; screening without available treatment

Discussion Questions:

  • What other ethical considerations are there to implementing POCUS in resource-limited settings?

       – Advantage: lack of need for significant infrastructure; skills can quickly be acquired; real-time video training/support between the United States and other countries

        – Limited support for continued supervision/continual mentorship on improving skills; sustainability of training programs

        – Potential costs of training

  • What to do when you come across findings not consistent with physical exam– how to advocate for further diagnostics/evaluation?
  • Using US for central lines: lack of US availability; no formal US training; need to teach how to use US, but also important to teach things such as sterile prep/technique

Why do we have a desire to work in Global Health? By Cody Ritz

Chapter nine from Reimagining Global Health: An Introduction aims to explore a few different answers to this complex question. It’s possible that many of our desires to work in Global EM stem from some of the moral frameworks or values systems presented in these pages. The chapter lays them out as such:

Depending on your own personal motivations, you may identify with one, many, or none of these moral frameworks or value systems. This list is not meant to be exhaustive, and it barely scratches the surface of the many nuances included in each of these philosophies. While we could go to much greater lengths to wholly explore these schools of thought, I believe the greatest benefit in naming them is not solely for the purpose of categorization. Rather, by taking the time to compare these sources of motivation, we can equip ourselves with a vocabulary and mindset that helps give form to our innermost determinations. While this form develops, we can begin to understand the foundations of our own interest to work in not only global health but medicine at large. As we come to better understand ourselves, let us hope this allows us to better understand others as well.

Discussion Points:

  • With which of these frameworks/value systems do you identify personally? – One? Multiple? None of them at all? – and how has that framework informed your own perspective and approach to global health?
  • Imagine that you’re in an interview for a position you want in the future and the interviewer asks—Why do you have these interests in global health when there is already great need within your own backyard?— How do you respond? In what ways could you explain your motivations within the frameworks discussed in this chapter?

Wrap up!

As you can imagine, our mentees had a wonderful discussion surrounding these three topics! We are thrilled to be able to present a brief summary of their work here. Please stay tuned for details about our upcoming meetings.  Connect with us through one of our contact options listed below if you are interested in attending!

Thank you to our authors and presenters!

Holly Farkosh, MS4

Holly Farkosh, MS4

Marshall University School of Medicine

Cody Ritz, MS2

Cody Ritz, MS2

Drexel University College of Medicine

Keep in Touch:

Cite this article as: Global EM Student Leadership Program, "Journal Club 11/29/21: Ethics of Humanitarian Work," in International Emergency Medicine Education Project, April 6, 2022, https://iem-student.org/2022/04/06/journal-club-11-29-21-ethics-of-humanitarian-work/, date accessed: October 2, 2022

Journal Club 11/08/21: Resource Equity in a Pandemic

The Global Burden of Schistosomiasis presented by Farah Mechref

Endemic in 74 countries across Africa, the Middle East, South America, and Asia, schistosomiasis is a neglected tropical disease caused by flatworms or blood flukes known as schistosomes. About 440 million individuals are infected with these trematodes, which reside in the blood vessels of their definitive host and lead to different clinical manifestations depending on the species. In regions endemic for schistosomiasis, the most prevalent form of the disease is
chronic schistosomiasis, resulting from repeated immunological reactions to eggs trapped in organ tissues. Infection begins when individuals enter bodies of water that contain contaminated snails that have released infectious cercariae. These cercariae penetrate the skin of the human host and produce an allergic dermatitis at the site of entry or a “swimmer’s itch.” Antigens are then released from their eggs, which stimulates a granulomatous reaction composed of T cells, macrophages, and eosinophils, resulting in the clinical disease. 

Acute schistosomiasis typically presents with sudden onset of fever, malaise, myalgia, headache, fatigue, and abdominal pain lasting 2–10 weeks, with eosinophilia noted on lab findings. Chronic infection cause granulomatous reactions and fibrosis in affected organs, which results in clinical manifestations
that include: 

-In S. mansoni and S. japonicum: upper abdominal discomfort that then shows palpable, nodular hepato-spenlomegaly with eventual development of portal hypertension from fibrosis of portal vessels and resulting ascites and hematemesis from lethal esophageal varices.

-In S. haematobium: hematuria, which is so endemic that it’s thought to be a natural sign of puberty for boys and confused with menses in girls, with eventual development of squamous-cell carcinoma of the bladder.

Currently, the only control measures available include (1) mass treatment with Praziquantel (Biltricide) in communities where schistosomiasis is endemic, (2) introduction of public hygiene programs to provide safe water supplies and sanitary disposal of stool and urine, (3) snail eradication programs using molluscicides, and (4) vaccination development to create a more durable and sustained reduction in transmission.

Discussion Questions:

  • Knowledge of transmission and preventative measures play an important role in schistosomiasis control, what other endemic conditions could be better tackled with improved patient education?
  • With 230 million actively infected patients and another 200 million with latent infections, is a vaccine worth the resource distribution or should funding go towards expanding the anti-parasitic classes available for treatment? 

Resource Equity in a Disease Outbreak by Alison Neely

The Ebola virus disease of 2013-2016, centered in West Africa, was considered one of the most threatening cases of infectious disease outbreak in modern history up until the emergence of Covid-19 in 2019. Due to the high case fatality rate of Ebola, the core element of the outbreak response was effective case identification and rapid isolation; treatment centers were quickly overwhelmed and experienced limited bed supply and staff time. A study drawing from interviews with senior healthcare personnel involved in this Ebola outbreak response aimed to identify the ethical issues involved in such a response and to create a framework of ethical guiding principles for future responses.

The framework proposed after analysis of the participants’ interviews was split into four categories: community engagement, experimental therapeutic interventions, clinical trial designs and informed consent. Community engagement stood out as a key element both in the framework and in the journal club discussion that followed. Engagement can include promotion of collaboration and open dialogue, incorporation of community insights into decision-making processes, encouragement of transparency, building trust, and reflecting on context-specific cultural values. As future physicians with special interest in global medicine, these ideas of respecting cultural context and complete inclusion of the local community in response efforts were highlighted as very relevant to our future practice.

Discussion Points:

  • Have the principles presented here been followed in the global response to the Covid-19 pandemic?
  • Our discussion also focused on the parallels and differences between this Ebola response and the global response to the Covid-19 pandemic, calling attention to the ways that the response both followed and diverged from the framework presented in this article. As the idea of a disease outbreak has become part of daily conversation in the last 2 years, investigations and discussions such as this will become increasingly relevant and important. We also touched on the idea that our global response to Covid-19 may have been very different, and potentially weaker, if the Ebola outbreak had not occurred when it did.
 

Wrap up!

As you can imagine, our mentees had a wonderful discussion surrounding these three topics! We are thrilled to be able to present a brief summary of their work here. Please stay tuned for details about our upcoming meetings.  Connect with us through one of our contact options listed below if you are interested in attending!

Thank you to our authors and presenters!

Farah Mechref, MS4

Farah Mechref, MS4

Texas Tech University Health Sciences Center

Alison Neely, MS4

Alison Neely, MS4

Albert Einstein College of Medicine

Keep in Touch:

Cite this article as: Global EM Student Leadership Program, "Journal Club 11/08/21: Resource Equity in a Pandemic," in International Emergency Medicine Education Project, February 23, 2022, https://iem-student.org/2022/02/23/resource-equity-in-a-pandemic/, date accessed: October 2, 2022