Akutmedicin som medicinsk specialitet i Sverige, uddannelsesaspekter Maaret Castrén Professor in Emergency Medicine Institutionen för klinisk forskning och utbildning, Södersjukhuset, Karolinska Institutet
Maaret Castrén 3 april 2008 2
Maaret Castrén 3 april 2008 3
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A subspecialty since 1.7.2007 Five specialists in Sweden Four at Södersjukhuset Maaret Castrén 3 april 2008 5
What has been done? Lisa Kurland 1. Curriculum Ministry of Health and Welfare 2. Detailed curriculum 3. Overlapping rules Maaret Castrén 3 april 2008 6
Aims Mål Metoder för lärande Uppföljning 1-Att kunna identifiera patienter 1-Kliniskt arbete under 1-Granskning av med svåra, potentiellt livshotande tillstånd handledning 2-ST-seminarier 3-Simuleringsövningar utbildningsdokumentation 2-Specialistexamen Maaret Castrén 3 april 2008 7
A speciality in emergency medicine Emergency Medicine Emergency Medicine + bas Lisa Kurland, målbeskrivningsansvarig, m SWESEM lisa.kurland@medsci.uu.se Maaret Castrén 3 april 2008 8
What has been done? 1. Loggbook 2. Material for education Practise and theory Every region has a coordinator for education 3. Written exam Voluntary, but recommended Maaret Castrén 3 april 2008 9
Educational program I. Resuscitation and primary triage CPR A Airway B Breathing C Cirkulation D Disability E Exposure II. Symptoms III. Diagnoses Skills V. Ledarship VI. Communication VII. Research VIII. Education Maaret Castrén 3 april 2008 10
SoS s kritik av rådande r system Teoretiska inslaget för f r lågtl Verksamhetschefens dubbla roll som utbildningsansvarig och som examinator Kvalitetsbrister (handledning/ planering/ uppföljning) Konflikten utbildning-sjukv sjukvårdsproduktion Det svenska systemet: osystematiskt och ineffektivt Splittrat ansvar för f r specialistutbildningen Teoretisk utbildning Sverige svag jmf med andra länderl Teoretiska moment förtydligas f i målbeskrivningar m och i ansökan om specialistbevis Centrala teoretiska moment bör b r vara obligatoriska Kurser (SK- och liknande) bör b r innehålla kunskapskontroller Lisa Kurland, målbeskrivningsansvarig, m SWESEM lisa.kurland@medsci.uu.se
Aim of the education Ministry of Social Affairs and Welfare Emergencies Emergency room Prehospital setting Disasters Organization of recourses Akutläkare Lead, practise and develop Prevent Maaret Castrén 3 april 2008 12
Competence in communication Patients are equal and take responsibility Manifold and sex aspects Inter-professional relations Pedagogic skills Professional approach and ethics Own competence development Maaret Castrén 3 april 2008 13
Competence in leadership How to be A co-worker An instructor A leader Knowledge of the system Maaret Castrén 3 april 2008 14
Real life The demands for emergency departments has increased Year 1970 there was 115 hospitals with ED s 24/7 for a population of 8,1 miljon. Year 2003 there was only 60 left At the same time The population has increased to 9,0 miljon The median years to live increased from 71,7 to 78,0 years Hospitalbeds decreased to 80 procent from 120000 to 27000 Maaret Castrén 3 april 2008 15
A survey 2007 Urban Säfwenberg Questionnaire for all 74 ED s in Sweden 61 answered (82.4%) 8.8 milj people, 97% of all Sweds Three groups 90000 inhabitants 90000 240000 inhabitants >240000 inhabitants < 50% was an own activity Only 22 % (13) had their own budget for physicians One year after recognition of the new speciality there was 162 registered in programs for becoming emergency physicians Maaret Castrén 3 april 2008 16
A questionnaire 2007 Emergency medicine a part of daily life in 11 hospitals 5 specialists and 162 started specialistprograms An other 12 hospitals has plans to start in 2 years Maaret Castrén 3 april 2008 17
The academic world The first professor in emergency medicine 1.1.2007 The first lector in emergency medicine to be announced 4/2008 Maaret Castrén 3 april 2008 18
The role of ED Changed from a channel in to the hospital to a place where diagnosis and treatment are given and patients treatments are started or they are sendt home Maaret Castrén 3 april 2008 19