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Emergency Medicine effort in Guyana reaches milestone

Jan. 9, 2014, 9:41 AM

Corey Slovis, M.D., conducts a class at Georgetown Public Hospital Corporation as part of Vanderbilt’s Emergency residency program in Guyana.

Vanderbilt’s Emergency Medicine residency program in Guyana graduated its first resident Nov. 22, 2013, marking a significant milestone in a decade-long effort to establish the country’s first Emergency Medicine program and department at Georgetown Public Hospital Corporation (GPHC).

The first graduate, Zulfikar Bux, M.D., has been named director of the Department for Accident and Emergency at GPHC and will lead efforts to establish an Emergency Management System in his country. Also, Bux will collaborate with Nicolas Forget, M.D., residency director of Vanderbilt’s Guyanese residency training program, to select and develop subsequent emergency physicians.

“The graduation of Dr. Bux is a milestone for the Georgetown Public Hospital Corporation and the Vanderbilt Emergency Medicine department’s Guyanese residency training program,” said Cathryn Rolfe, J.D., chief business officer for the Office of Health Sciences Education and director of International Clinical Initiatives for VUMC.

“The delivery of health care in Guyana has been and will be affected for decades to come as a result of the investment and leadership of our Emergency Medicine department. This collaborative training program is a stellar example of what academic medical centers should strive for — sustainable ‘capacity building’ training programs with developing country partners,” she said.

The Vanderbilt-Guyana partnership was conceived in 2003 with the vision of then-chief resident in Emergency Medicine John Paul Rohde, M.D., now assistant professor of Emergency Medicine and director of the adult Emergency Department, who spent part of his childhood living in the South American country. The program now has 11 residents enrolled.

“The graduation of the first resident in Vanderbilt’s Guyanese residency training program represents the birth of Emergency Medicine as a specialty in Guyana,” said Rohde. “Guyana is now poised to experience a dramatic increase in the quality of Emergency Medicine and to enjoy the capacity to train its own emergency physicians into the future.”

Each Guyanese emergency medicine resident spends one month at Vanderbilt training with Vanderbilt residents and faculty. Additionally, many of Vanderbilt’s Emergency Medicine residents have gone to Guyana to teach and practice alongside Guyanese health care providers under the supervision of Vanderbilt faculty, who rotate in Guyana on a regular basis with one faculty member or international medicine fellow there at all times.

“Rather than sending our doctors down there to provide care to some patients and then leave, what we wanted to do was to create a lasting and permanent change in the health care of that dramatically underserved nation,” said Corey Slovis, M.D., professor and chair of the Department of Emergency Medicine.

“We thought the best way to do that is to train residents in Emergency Medicine who would then stay in Guyana as Guyanese citizens and be able to provide emergency care, and the program’s success has been wildly beyond our dreams.”

Additionally, many Vanderbilt emergency nurses have traveled to Guyana to train their nursing staff on the fundamentals of triaging patients and treating patients in order of acuity.

“We didn’t think it was possible to change the way emergency medicine is practiced [at GPHC] without also changing emergency nursing,” Slovis said. “Our nurses have changed how that emergency department works, and although it’s not a mirror image, there are now many similarities to how the Vanderbilt Emergency Department works. It is a beautiful sight to behold, being so far away from home but in an emergency department that functions very much like ours.”

Slovis says Vanderbilt residents who travel to Guyana have the opportunity to develop their clinical decision making skills to a higher degree, with treatment based on physical exam, ultrasound and limited lab tests and not on unlimited radiology, extensive lab work or consults with specialists as it would be in American hospitals.

“This experience makes our residents better doctors, makes them appreciate resource utilization and allows them to hone their clinical decision-making skills,” Slovis said.

Improved ambulance services countrywide are being planned for the start of 2014 in collaboration with Vanderbilt Emergency Medicine and funded by a grant from the Morris Family Foundation.

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