Collaboration Yields Insight on India’s Emergency Medicine Curriculum, Training Needs

In 2014 the Society for Emergency Medicine India (SEMI) and BU agreed to collaborate on ways to help further develop emergency medicine (EM) activities in India in the areas of research, rural emergency medicine and faculty development.

As part of this collaboration, the first paper was published in the World Journal of Emergency Medicine, “Acute Care Needs in an Indian Emergency Department: A Retrospective Analysis.” Assistant Professor of Emergency Medicine Gabrielle Jacquet, MD, MPH, is corresponding author.  Jacquet also serves as assistant director of the BUSM Global Health program.

The paper is is based upon a retrospective study by Jacquet and colleagues from the BU School of Public Health; Boston Medical Center; BU Center for Global Health and Development; and Kerala Institute of Medical Sciences, Trivandrum, Kerala, India. It provides baseline documentation on disease burden and resource utilization in an Indian emergency department. The analysis reveals some differences between India and the U.S. Because most Indians pay for medical services out-of-pocket and are not protected by insurance or legislation like the Emergency Medical Treatment and Labor Act  (EMTALA) that require the ED to treat them, Indian self-referral patterns are much different than in the U.S. The ED is a medical resource of last resort in India and as such, the acuity of patients presenting to the ED is typically higher than in the U.S. Another important difference is the frequency of infectious disease as a presenting condition in the ED. These differences suggest the acute conditions addressed in EM curriculum and training in India may be different from those in the U.S. or other high-income countries.

This is the first known documentation of case-mix and epidemiology in an Indian ED. The authors recommend the study be extended to a variety of hospitals, and that the results be used to further inform Indian EM training and faculty development.