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certification, triage and destination decisions. Most learning based on practice, professionalism, and systems -
ambulances offer Basic Life Support (BLS/Type 2) with a based on practice (medical knowledge has been excluded).
growing minority offering Advanced Life Support (ALS/
Type 3). The medical residency programs were established EMERGENCIES IN THE PACIFIC: AUSTRALIA
5 years ago and form the basis of training specialists in AND NEW ZEALAND
emergency medicine for the UAE. This article describes
the full spectrum of emergency medicine in the UAE: pre-
hospital care, EMS, inpatient emergency care, emergency • Speciality: 1993 (Aus) 1995 (NZ)
medicine training and disaster preparedness. We hope • N of Doctors/inhabitant: 3.68‰ (Aus, NZ)
that our experience, understanding of the challenges
facing the specialty, and anticipated future directions will • Number of emergency physicians: 1761 (Aus) 225 (NZ)
be important to others advancing emergency medicine in
their region and around the world . • Paramedics base system
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Paramedic services in Australia and New Zealand
US: (Australasia) share many characteristics, with both
offering versions of the Anglo-American emergency
• Speciality: 1972 medical response system. The main difference between
the two countries is in their sources of funding, with
• N of Doctors/inhabitant: 2.61‰ Australian paramedic services generally receiving more
government funding than those in New Zealand. Both
• Number of emergency physicians: 48,835
countries offer a range of services that use a mix of
• System • Peculiarities: Chicago > 20 Firearm Wounds/d volunteer and professional staff and employ state-of-the-art
communication and medical technologies to provide high-
With the creation of the specialty of emergency medicine level clinical services. Like other high-income countries,
in 1972, the United States experienced a low period 20 they face the challenge of increased use associated with
years ago with a disaffection of the specialty of emergency aging populations. Both countries are adapting to this
medicine. Thanks to an active recruitment campaign and by expanding their response models from a focus on
no doubt probably thanks to the TV show «ER» (from emergency medical response to providing a mobile health
Michael Crichton) in the 1995, the specialty of emergency service that will see the emergence of more paramedical
medicine in the United States is one of the 3 famous roles. These emerging models challenge the fundamental
speciality by students. in medicine. Attractive, this specialty missions of paramedic services, as well as the professional
has become more feminized with work rotation schedules identity of paramedics.
generally 3 shifts per week.
The development of the Anglo-Saxon or European model
Currently, 3 emergency medicine companies dominate in of MU training Emergency Medicine Education initiatives
the United States the SAEM ACEP and AAEM. are increasingly developed globally through national and
international EM organizations.
The training of young doctors is developed through
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comprehensive programs integrating simulation . Lack of resources and funding capacity in some countries
may hamper the development of specialties.
There is no Virtually no experience of pre-hospital medicine
in the United States, but feedback from the Boston attacks The continued growth of the specialty in these countries
in Las Vegas has made it possible to develop pre-hospital requires an understanding of their health priorities
medicine programs based on disaster medicine. and the global health and development agencies that
often help these countries support the health sector.
In 1999, the Accreditation Council for Higher Medical Emergency medicine residency programs address the
Education (ACGME) identified six general competencies need for physicians trained in emergency medicine in
as the basic educational objectives required by all training emergency departments. The Accreditation Council for
programs for their residents. A consensus workshop held Higher Medical Education (ACGME) Residency Review
at the 2006 Council of Emergency Medicine Residency Committee ensures that all programs have a structured
Directors (CORD) «Best Practices» conference identified curriculum that includes both didactic and bedside
specific measures for five of the six skills in emergency teaching, as well as structured methods of assessment
medicine - interpersonal communication skills, patient care, of residents and faculty. There are three- and four-year

41 | REBRAME | REVISTA BRASILEIRA DE MEDICINA DE EMERGÊNCIA