Local Emergency Physician Aids In International Emergency Medicine Development
30 August 2000
Hershey, PA. -- The level of emergency care characterized in the TV show "ER" is something that many Americans take for granted, but reliable emergency care is a luxury not available in many countries. C. James Holliman, M.D., associate professor of surgery at Penn State's College of Medicine, is working to change that. He has been involved with the development of emergency medicine as a specialty in many countries, including Slovenia, Croatia, Turkey, China and Korea.

"'ER' has been a stimulus for many countries," Holliman says, explaining that the show's popularity has increased the awareness of emergency medicine internationally. Holliman's own involvement stems from an international conference in Britain that he attended as a junior faculty member. "I realized that there is very little emergency medicine in the rest of the world," he remembers. Since then, Holliman has been working to help other countries develop emergency departments similar to those in the United States.

The first step in this process is to assess what the country's needs are and what resources it has to offer. Next, hospital-based emergency departments are created. Only when these departments have been established can an ambulance system of prehospital care can be developed.

There are two basic models for emergency care: the familiar U.S. model and the Franco-German model. In the Franco-German model, ambulances are staffed by physicians instead of paramedics. Holliman explains that some countries have a surplus of doctors, making this a more attractive option than the U.S. model. It is still important, however, that these doctors receive adequate training in emergency medical techniques.

In countries with no pre-existing emergency medicine infrastructure, the most difficult obstacle to establishing emergency departments can be training the physicians. According to Holliman, there are several ways a country can train its first emergency physicians. Interested doctors can participate in emergency medicine residency programs in the U.S., and then train residents in their home country. Another option is for U.S. emergency physicians to travel to other countries and train physicians there. Such visits can be short, or physicians can spend a year or more establishing an emergency physician residency program.

An article co-authored by Holliman, "Planning Recommendations for International Emergency Medicine Development" will be published in the August issue of Academic Emergency Medicine. According to Holliman, this is the first document that explains how to develop emergency medical systems in other countries.

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