Nurturing a New Specialty: Challenges from Communities and Cultures in Transition ! My Thoughts on Educating New Specialists !

From the Desk of
Sagar Galwankar, MD

Developing Emergency Medicine in a nation which never had this specialty is one of the biggest changes a nation can ever witness.

Transforming existing Emergency Infrastructures or developing new emergency medicine departments is something which is challenging and demands a lot of patience and tenacity.

I have always believed that Academic Medical Colleges are the ideal locations to develop any new specialty because Education is the key to sustainable growth of trained specialists.

Many practicing physicians see the importance of emergency medicine and want to develop the department and the services at their facilities. They often unite and establish forums societies and networks to increase awareness and advocate the need for this specialty with the regulatory bodies.

Well these are important points similar to any revolutionary movement in any nation BUT the core challenges lie after the specialty is recognized and gains momentum.

Important Questions facing any new specialty are:
1. Sustainable Growth
2. Economic Advantage
3. Research Development
4. Educational Innovation
5. Policy Development

Today I will address the Importance of Education and its role in growth:

Education and Training are not simple and trivial  issues. Mentoring is an integral part of training but Training does not mean Mentoring alone. 
As regards to EM , when we have to develop the specialty from scratch , the trainers will be transitioned from Anesthesia, Medicine, Surgery etc. This is because EM does not have a parent discipline and Emergencies happen in every specialty. Emergency Medicine involves training on knowledge about managing every emergency from any specialty. In early years when diverse Faculty adopt and adapt to be trainers they come from different specialties. Its not astounding that their backgrounds will play a major role on the training imparted to the new residents in EM. The maiden teachers should realize that they have adopted the new specialty and they have to commit to it. They are expected to be aware of the body of knowledge and train the residents as well train themselves in the new specialty.

For Example: In Emergency Medicine the trainers may be from a background In surgery. It is imperative that the New Surgeon-Emergency Medicine Educator learns to manage Medical , Pediatric Emergencies,  toxicology and gains the competency over the next few years and continues to train the new residents in EM. 

Academic Commitment demands that residents get the correct education which makes them competent and in turn develops the specialty at large.

There are instances when enthusiasm  can go overboard in the quest to establish the new specialty. Advocacy by health leaders can create residency programs in jet speed. The challenge here is who will impart the training and are there enough educators ?

Academic Training has to be Continuous and Persistent to create a sustainable process leading to the manufacture of a constnat supply of competent specialists.

Modeling and Process Management with Continuous Quality Improvement based on generated Evidence and Innovation are core fundamentals of Academic Education and Training.

When importance of Education is Undermined the sustainability of quality driven growth is compromised in exponential ratio.

It is important that New Specialty Trainers from diverse disciplines adopt and adapt to the new specialty and train the residents honestly thus growing themselves simultaneously.
It is Important that advocates realize that sustainable growth comes via Quality Training and not enthusiasm alone.
It is important that we realize that establishing a specialty is easy, growing it and Nurturing a Positive Growth is more challenging !

Education and Commitment to Education is an Important pillar to this castle of growth.
All Educators are Enthusiasts that is why they do what they do, 
But not all Enthusiasts can be Educators !