CPSP trying to promote Emergency Medicine by organizing training of postgraduates in Ireland

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CPSP trying to promote Emergency Medicine
by organizing training of postgraduates in Ireland

By Shaukat Ali Jawaid

KARACHI: Emergency Medicine is an emerging new discipline of medicine which is now very well established in the developed world. However, in Pakistan this important specialty has remained neglected so far. It was only few years ago that College of Physicians & Surgeons Pakistan decided to award Fellowship in Emergency Medicine and have accredited two institutions one in Islamabad and one in Karachi for training. They can accommodate only a few postgraduates. Hence in order to promote this discipline CPSP has signed an agreement with Ireland to arrange training of its postgraduates in Emergency Medicine for a period of two years.
Responding to an advertisement on CPSP website, over forty postgraduates applied for training in Ireland. They were interviewed by a team from CPSP on phone and they shortlisted twenty two candidates, three from Peshawar, Three from Faisalabad, Two from Hyderabad, Twelve from Lahore and two from Karachi. They were then interviewed through Video link at CPSP regional offices and at Karachi Office by a team of experts from Ireland. It consisted of Dr. Robert Eager, Dr. Aiden Gleesan and Dr. Jamal while Prof.Mahmood Ayaz, Prof.Khalid Masood Gondal coordinated at CPSP Regional Center Lahore and Prof.Rizwan Azmi at CPSP offices in Karachi. At other centers the IT staff helped the candidates. The interviewers went on well except a brief few minutes disturbance for which credit goes to the efficient audiovisual team and IT department of the CPSP.
I had the opportunity to see this whole process of interview at CPSP Karachi offices thanks to an invitation from President of CPSP Prof. Zafarullah Chaudhry. It was a unique and fascinating experience. Some of the questions which were asked from the candidates included details of their training since graduation, for how long and in which institution they had worked so far, their present job description, why they were interested in the discipline of Emergency Medicine, were they keen to continue in this discipline, what do they know of Emergency Medicine in Ireland and why they want to come to Ireland for training in Emergency Medicine. Other questions asked included where do they see themselves after ten years from now onward, would they feel comfortable attending medical, surgical and paediatric emergency including trauma cases, have they attended any courses like ATLS, ACLS, BCLS etc. Have they ever handled trauma cases, do you Thrombolyse the patient if need be or refer it to the cardiology department, CCU, have you ever managed minor trauma, minor surgery etc. Then each candidate was asked to come up with differential diagnosis in two different clinical scenarios. One was intense severe worst type of headache in a young girl while the other scenarios was of low back pain in an elderly man of over sixty years. In the first case majority of the candidates diagnosed it as SAH while a few also added that it could be due to raised IOL pressure or it may be tension headache, or migraine. When asked how they will diagnose SAH, most replied by CT Scan of Brain and when asked if the CT is normal what will be their next line of investigations to which majority mentioned Lumber Puncture.
In the second case, a few could name the diagnosis immediately but some others could get to aortic aneurysm when they were provided additional information like abdominal discomfort and low blood pressure. On the whole most of the candidates were good enough but some could not give correct replies as they did not listen to the question carefully. Some were very confident but a few were seen lacking in self confidence and were seen repeating Sir after every reply or would first repeat the question before coming up with the answer. Aortic aneurysm may be quite common in the West but is not seen so common here, hence many of the candidates did not mention it in the beginning. At least two of the candidates were not good at communication. The team from Ireland also gave an opportunity to the candidates if they wanted to ask them any question. Some of the candidates availed this offer but the questions they asked were not so relevant and related to details of training like the place they will be posted, leave in case of an emergency back at home in Pakistan, which has to be looked into in the second part after the candidates have been selected. They were assured that those selected will get the same training which is available to other postgraduates and they will also be entitled to the same leave and other privileges etc. A vast majority of the candidates which appeared in the interview were quite competent and only needed a little bit of polishing which could convert them into diamonds. This interview through Video link is extremely cost effective, feasible, and practical for which CPSP administration deserve to be commended to have made all these arrangements.
The interviewing team from Ireland will now present its report to the Irish Committee of Emergency Medicine Training based on which the final selection of candidates will be made who will be invited to Ireland for a Two years training in Emergency Medicine. Hopefully once they return back to Pakistan, it will not only help improve the Emergency Medicine care but also create opportunities for training for postgraduates interested in taking up Emergency Medicine as career.

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