Transcript Emergency Medicine in Jordan

Emergency Medicine in Jordan
Rashed Hijazi MD, FRCSEd (A&E)
Consultant EM
Pre-hospital care ( Public )
Covered by the civil defense directorate
Multiple locations with 2 ambulances for
each
2 crew members in each ambulance
Supplied with basic equipment
Dispatch by central communication center
Transportation time: average 10 minutes
Level of training: 6 months, started in
1988, 3 months theoretical, 3m. practical
BLS and first aid , no invasive procedures
New regulations in progress for advanced
medical protocols for IV access, drugs,
defibrillators, etc.
Dispatch to the nearest public hospital,
unless life threatening situation, then
nearest private or public
Communication with hospitals
Funded by ministry of health
Free for the public
The Royal medical services (Military Sect.)
Air medical evacuation by the Jordanian
air force for eligible patients
Civil Defense
(public)
Ambulance Calls
2002
56500
56000
55500
55000
54500
54000
53500
53000
52500
52000
Death Rate
2001
1030
1020
1010
1000
990
980
970
960
950
940
2001
2002
Type of Call
40000
38769
35000
30000
25000
20000
15000
10000
5454
5000
2960
2562
2450
0
Medical
Falling
down
Delivery
MVA
Trauma
Pre hospital Care ( Private )
Each private hospital runs its own ambulances
Medical services on special request only
High standard , well equipped
Recently started mobile intensive care units
Ambulance crew including a physician
Dispatch by the private hospital if called upon
Retrieval to the same hospital only
No communication with other private hospitals
Funded privately or by private health insurance
The Jordanian Board In
Emergency Medicine
Independent specialty since July 99
Five approved training centers
Registration in the medical association
 Four year program
 Part I during the 2nd year
 Only successful candidates are
promoted to the 3rd year
 Board exam after 4th year
Training Program
- Established after reviewing
-
-
Australian, American, Canadian and
European programs
Independent specialty
Started 1st at Jordan University 1998
7 candidates at start of program
5 candidates obtained Jord. board
1st Year
General Medicine
3m
ER
3m
General Pediatrics
2m
General Surgery
2m
Orthopedic
2m
2nd Year
OB & Gyn.
1m
ER
3m
ER Ped.
2m
CCU
2m
ICU
2m
Psych.
2m
3rd Year
ER
ER ped.
ER Adm.
Anesth. Plast.Surg
2m
1m
1m
1m
1m
Neur.Surg Ped.Surg Forensic Research Elective
1m
1m
1m
1m
2m
4th Year
ER 12 months
Senior : Clinical & administrative
Medical, Surgical, Pediatric and
OB/Gyne.
Program Activities
Emergency medicine topics
Emergency Surgery topics
Pediatric Emergency topics
Obstetrics & Gynecology topics
Mortality & Morbidity
Journal Club
Radiology
Case presentation
Principles and basic science
Program Progress
Periodical evaluation
End of year examination
Written, Oral and Clinical
Pass mark 60%
Publication
Program director
Committee ( From other specialties )
Successful : Jordanian Board Certificate
Exemption of part1 Arab Board
Unsuccessful : 3 trials with conditions
EM Training Centers
Jordan University Hospital ( 1st center )
- Started in July 1998
- Jordan University has 550 beds with
60,000 visits to the ER per year
- Requirement, selection criteria
EM Training Centers
KA University hospital
1st Yr #3 candidates
2nd Yr #4 candidates
Commenced June 02
Ministry of Health hospital
1st Yr #5 candidates
Commenced June 03
Military hospital
1st Yr
Private hospital
1st Yr #1 candidate
2nd Yr #1 candidate
Challenges
New specialty
Shortage of ER physicians
Limited understanding
Under-estimation
Lack of support
Financial
Staff
Facilities
Regulations and guidelines
Future and security
Optimistic outlook
Population and need
High incidence of trauma
Increasing No. of Private hospitals
Competitive other specialty
Establishment of the Arab Board in
EM
International applicants
Other specialties applicants
Strong link with Family medicine
Improvement
More ER physicians
Supervisors and trainers
Introduction of academic courses, eg:
ACLS, ATLS, U/S etc.
Advertising
Legal and ethical issues
Conferences
Establishment of an EM association and
Collaboration with others
Communication and reciprocal recognition
Summary
New developing specialty among
well developed and high standard
medical services
The future is bright
High spirit present
International support needed
Thank you