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(This thread was posted by by Dr. Sarvesh Jain via email)

Dear friends

It is really hopeless to see condition of A&E concept in India,
for some time I have been in UK,there I saw a separate entity of doctors ,known as emergency room house officer and registrar
they were perfectly trained in there field and supervised by consultant qualified and licensed by independent body (Like Royal college of A&E )
they have there definite protocol (even defining priority of putting oxygen mask or taking ECG)

now it's time to tell Indian scenario (I am telling about 1000 bedded teaching hospital of new Delhi with all major speciality and even super speciality DNBs)

A&E runs by CMO(casualty medical officer,mostly they were MBBS without any course specialised to A&E) they mainly concentrate legal aspect of injury and post mortem
CMO assisted by JRs(most of them were preparing for prepg,and lacked any definite experience in ER,there main concern were passing time and earning money for next prepg)
sometime medics in ER ,start putting suture even before securing IV cannula and resuscitation of shock

So this is the scene

Now what should we do to change ?

dr Jain

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Dear Sarvesh, Use the discussion forum to post your opinions and questions.

Go to Main Page > Discussion Forums > General > How to start a discussion thread

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Hey Sarvesh
Don't be disheartened. It takes time to accept and embrace change (more so in our country).

This is a relatively new specialty in India (for that matter in most countries). Howver, there are already a lot of Institutes following systems similar to that you have mentioned. I certainly don't think you could generalise this.

With so many 'courses and qualifications' in EM flying around, it won't be long before every institute starts marketing their own brand of emergency medicine. One can only hope that this is going to be 'world class'.

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I am happy with maroju's answer (b/c something is going terribly wrong and people are aware of it)

But I suggest we should start our own course like "indian society of critical care medicine"(they are offering 1 and 2 year courses) with standard equivalent to any independent overseas body

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Be very very clear of one thing.

EMERGENCY MEDICINE and CRITICAL CARE are two very DIFFERENT specialties.

Go to this url to know the differences
[url]http://www.emergencymedicine.in/EMFAQ/EMdiffcritical.htm[/url]

Emergency Physicians have very different skills from what Intensivists have. Although the airway management and a few other skills are common to both specialties.

EM already has its own society in India called SOCIETY OF EMERGENCY MEDICINE, INDIA (SEMI) which was formed in 1999.

There are already PG courses for emergency medicine in India. All of them are concentrated in South India.

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Could I add that in the UK, Intensive Care is one of only two specialties (the other being Acute Paediatrics) in which an EM registrar could work towards 'dual accreditation'. Of course this is only after appropriate training and assessments by the relevant governing bodies.

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I think Emergency medicine and Intensive care are closely knitted as Anaesthsia and Intensive care.There is no Intensive care Training as such in most of the countries and Anesthetists take over IC(Intensive Care)after some training/experience in IC(that is the case in UK might be different in USA).
So its time for IC to be different speciality and proper training(may be too ambitious) but in the meantime i don't find any fault with EM guys getting dual accredition in EM and ICU as the Anaesthetists are doing.There is some argument about skill sets but i think all the three specalities cover the common generic skills in their respective training it is up to the awarding body to make sure the person attains particular IC skills before the accredited.
In UK EM guys can brach out into 4 different directions EM+IC, EM+PEM, EM+ACUTE MEDICINE, EM+ACADEMIC EM.

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I think Sarvesh was suggesting an EM course 'on the lines' of ISCCM courses!!! He wasn't suggesting a 'Critical Care Medicine' course for EM physicians.