Fellowship Training

International EM Fellowship

Introduction | Clinical Core Content | Yearly Summaries | Appendix A | Current Projects

Introduction and Overall Goal of the Fellowship

The University Emergency Medicine Foundation and Brown University will jointly manage a Fellowship in International Emergency Medicine (IEM). A total of 2 Fellows will be trained under a two-year curriculum with 1 Fellow in each year. The program requires all entering Fellows to complete an MPH unless a higher level of academic training has been achieved in an effort to broaden the trainee’s experience and enable the Fellow to meaningfully accomplish research. The two years will provide the Fellow with opportunities to train in IEM.

The overall goal of the Fellowship is to produce an individual who possesses the necessary skills to pursue a number of different potential career pathways within the rather broad field of (IEM). After completion of the Fellowship, the individual should be competent in teaching IEM, in the performance of research involving IEM, and familiar with administrative issues in the field.

Fellows will accomplish these goals over 24 months of rotations, with some portion of their time spent in hospital emergency departments affiliated with Brown.

Clinical Core Content

1. Core Content Objectives: The Fellow will learn the principles of IEM, and the options for a career in this field. These concepts would include:

• Acquisition of an MPH degree from Brown University, with a focus on some aspect of international studies relating to IEM
• Acquisition of certification in tropical medicine from the Royal College of Surgeons of Ireland
• As part of the MPH, pursuit of at least one major academic project for each of two years out of the country, in some aspect that involves one of the following:
  • Research
  • Quality improvement
  • Injury Prevention
  • Subspecialty areas within emergency medicine
  • Development of trauma systems, protocols and policies
  • Education and training of emergency physicians, or the local equivalent type of health care provider in various countries, nurses, and prehospital personnel
  • Development of emergency medical service systems.

2. Core Content Cognitive Skills: International emergency Fellows will develop cognitive knowledge of the areas listed in Appendix. They can and likely will develop an area of focus within IEM from this list in which they can pursue as a career pathway.

Implementation: Yearly Summaries

Year One
As a junior attending, approximately 20 hours will be spent in one of the UEMF Emergency Departments clinically, to generate income for the Fellow. They will begin a two-year Masters of Public Health degree program at Brown Medical School in which they will focus on acquiring public health concepts that are specifically applicable to international studies. First-year Fellows participate in a seminar series on research design, epidemiology and biostatistics. They should begin to apply these principles by participating in an ongoing research project that is in keeping with the goals of the Fellowship. Submission of a report or pilot study for publication is the desired goal for the first year.

Year Two
The Fellow will continue work clinically for an average of 16 clinical hours per week at a UEMF emergency department. During year two, the Fellow will focus on a research project with a significant block of time committed to completion of this research project which will be a requirement of Fellowship completion.

The Fellow will be encouraged to seek funding for research interests from outside sources, in close collaboration with the Fellowship Director. The Fellow will be strongly encouraged to submit research results for presentations at national meetings and to complete a manuscript for publication.

The Fellow will complete a Master’s Degree in Public Health.

Appendix A

• Emergency Medical System development: Fellows have the opportunity to work in developing emergency medical systems (EMS) in foreign countries. This could involve work in countries in early stages of EMS development as well as countries that have already formed an EMS system.
• Research: Through the year Fellows engage in one or more research projects related to international emergency medicine, with resultant manuscripts suitable for publication.
• Travel medicine: Fellows will learn the basics of providing patient care and serve as consultants for patients presenting to travel medicine clinics.
• Disaster medicine: Fellows can become involved in various international disaster medicine opportunities as they present. Locally, they will have the opportunity to serve as a member of the disaster medical assistance team (DMAT).
• Infectious disease: Fellows will learn the concepts of tropical medicine and imported tropical illnesses for patients seen in the emergency department or admitted with internationally acquired infectious diseases.
• Disaster relief and humanitarian assistance: Fellows can become involved in international disaster medicine opportunities as they present throughout the year and serve as a member of DMAT. Opportunities for humanitarian assistance and international relief are also available.
• Education in IEM: Fellows can become involved in IEM education locally, by providing lectures on IEM for the UEMF residency program, and through international educational programs conducted in foreign countries.

Current Projects

Eldoret, Kenya
Brown University partners with the Moi University School of Health Sciences (MUSHS) as a part of the ASSANTE consortium. Other academic partners in this consortium include Indiana University, University of Utah, Oregon Health Sciences University, and Duke. Originally established by Departments of Internal Medicine, the Academic Model for the Prevention and Treatment of HIV/AIDS (AMPATH) is used to care for more than 30,000 men, women and children in Western Kenya. Current EM trained Infectious Disease Fellow, Dr. Michael Waxman, recently spent one year working on HIV objectives at the Moi Teaching Referral Hospital (MTRH) Casualty Department. His presence in Eldoret fostered a growing relationship between UEMF, MTRH and MUSHS. Both Fellows and Emergency Medicine Residents alike have the opportunity to complete electives at MTRH. This international opportunity provides the fellow with tropical medicine exposure, extensive HIV and related disease experience and clinical/research experiences in an austere environment.

Monrovia Liberia
Brown University and UEMF are currently negotiating a consortium opportunity with the Yale University Department of Emergency Medicine and a newly developed non-profit organization called HEARTT (Health Education And Relief Through Teaching). HEARTT was established by Drs. C. Lynch and A. Sirleaf, with the mission to educate and assist the local health care providers in the development of a health care system and infrastructure in post-conflict Liberia. A current relationship exists with the President of Liberia, and with the John F. Kennedy Medical Center in Monrovia. Fellow opportunities in Liberia include extensive experience with tropical and HIV related diseases, and medical education and public health infrastructure development. Providence, Rhode Island is also home to a large Liberian immigrant group, and the fellow will have the opportunity to explore the emergency medical needs of this population.