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Customized training helps rural doctors meet emergency medicine needs

SEME learners participate in a simulation

This story originally appeared in the September 2015 edition of Hospital News

It began with coffee. Five emergency medicine physicians sat down on a cold January day to discuss the chronic shortage of access to emergency care in rural Ontario and consider what they could do to address the growing issue. By the time they finished their drinks, they had a vision for a program to train practicing physicians in smaller communities in a wide range of emergency medicine skills. That vision became the Supplementary Emergency Medicine Education program, based at Mount Sinai Hospital.

“We saw an opportunity to share our expertise and resources with colleagues in smaller centres by providing practical and relevant training, enabling our learners to better meet the diverse needs of their patients and communities,” said Dr. Howard Ovens, Chief of Emergency Medicine at Mount Sinai Hospital, part of Sinai Health System. As the Ontario Provincial Expert Lead in Emergency Medicine, Dr. Ovens is uniquely positioned to understand the challenges and opportunities facing this sector. Dr. Ovens founded the program with Drs. Shirley Lee and John Foote, part of his team at Mount Sinai Hospital’s Schwartz/Reisman Emergency Centre, and former Sinai colleagues Drs. Eric Letovsky, now Chief of Emergency Medicine at Trillium Health Partners, and Tim Rutledge, now CEO of North York General Hospital.

 

Offering professional training

This practical training program is the first and only one of its kind in Canada. Created in collaboration with the University of Toronto’s Department of Family and Community Medicine led by Dr. Lynn Wilson, and the Ontario Ministry of Health and Long Term Care, it recently received five years of funding from the Ministry following a highly successful three-year pilot.

Practicing physicians join an intensive 12-week program with training in many areas of emergency medicine. Through academic seminars with leading experts, workshops, simulations, mentorship, and hands-on training, participants get a practical education that prepares them for the needs of their community. Currently, some 350 teaching faculty conduct this training at 13 Ontario hospital sites. This preparation is supported by 90 free, open access e-learning modules, which have been visited by thousands of physicians from around the world since their launch.

“Many Canadians live in rural or semi-rural areas, and those communities need emergency medical care,” said Dr. Lee, Education Director for the Department of Emergency Medicine at Mount Sinai. She heads the program, developing all aspects of the curriculum and working closely with learners to ensure their success. She also keeps in touch with past participants to follow their progress. “This is a real, long-term solution to meeting those needs and building capacity – our graduates are now providing top-notch care in over 45 communities across the province.”

 

Spreading success

The program’s success has generated interest from across Canada and around the world. Dr. Lee is now collaborating with colleagues at the University of British Columbia to establish a similar program there.

The 39 graduates of the pilot program are quick to sing its praises, including Dr. Christine Pun, an Emergency Physician in Sudbury, Ontario. Dr. Pun works at Health Science North, the only hospital in Sudbury. Formerly a family doctor, she wanted to upgrade her skills and improve her confidence in her new role. As part of the emergency medicine team at this important regional hospital, she’s often called on to handle a wide range of acute emergencies.

“Because I’d been practicing medicine for a while and had emergency experience, I wasn’t sure that I would gain much from the program,” said Dr. Pun. “But I was amazed – I got a lot out of it, really valuable tips that I use every day. And now I’m passing that information along to my learners.”

Dr. Pun was particularly impressed with the high quality of the instruction, the practical nature of the training and how customizable the program was, with each participant working toward individual goals to meet their own – and their patients’ – needs.

 

Delivering care in the community

“By offering targeted and effective training to give them competence in emergency medicine, we’re helping local doctors give their patients the care they need, where they need it,” noted Dr. Lee.

The program is expanding, partnering with the Northern Ontario School of Medicine to provide even more diverse training opportunities for participants.

“I’m very proud of what Dr. Lee and her team have achieved so far with the Supplementary Emergency Medicine Education program, and what is yet to come,” said Dr. Ovens. “I look forward to spreading this initiative, sharing the expertise and experience we have developed.”