Home Institution: Carolinas Medical Center Main (CMC) in Charlotte, North Carolina. CMC is an 874-bed, community-based, tertiary care teaching hospital that serves as the only regional level-I trauma center, the State Poison Control Center, and is a tertiary referral center for Mecklenburg County and 16 surrounding counties in North and South Carolina. It is the flagship facility for the network that includes acute care facilities, subacute facilities, and clinics in North and South Carolina. The campus includes an adjacent 234-bed children's hospital, Levine Children's hospital, which is a Pediatric Level 1 trauma center.  Residency programs exist in all specialties including Emergency Medicine, which is a PGY 1-3 program that includes 42 residents.  Fellowship positions are offered in EMS, Toxicology, Ultrasound, Pediatric Emergency Medicine, and Disaster and Operational medicine. There are 41 academic faculty members in the Department of Emergency Medicine as well as 2 adjunct assistant professors in the Department of Emergency Medicine from Muhimbili National Hospital in Dar es Salaam, Tanzania. The Emergency Department at Carolinas Medical Center manages over 115,000 patients each year, or about 300 to 320 patients per day. The department features an unusually diverse mix of patient care opportunities including 30 percent medical, 27 percent surgical/traumatic, 25 percent pediatric, 15 percent obstetrical-gynecological, and 3 percent psychiatric and toxicological. Further, the socioeconomic diversity of our patient population sets us apart from other institutions. CMC ED physicians work in one of three adult treatment areas to which patients are triaged by acuity of illness, as well as a 21-bed Children's ED.   The Children's ED is first in the region that offers 24-hour emergency care for children in a family-centered environment. Three to six board-certified emergency medicine faculty members are present in the open areas 24-hours a day.

CMC Global EM fellows will be classified as junior EM faculty and will work clinical shifts in the CMC ED as the attending physician. In this capacity, their responsibilities will include delivery of clinical patient care as well as the supervision and education of CMC residents and advanced care providers.

International Partner Sites:
Emergency Medicine Department, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. MNH opened the first public, full service ED in Tanzania in 2009, and now sees a daily volume of 150-200 patients (20% pediatrics). Specialty clinics attend 1000 patients a day, and the hospital has a bed capacity of 1500 patients. All specialties are available at the MNH Campus including medical, surgical, cardiovascular, trauma, pediatrics, and psychiatry. Fellows wishing to treat patients will become licensed physicians in Tanzania. Medical licensure will be provided by the Medical Council of Tanzania for fellows wishing to treat patients. The Emergency Medicine Department at MNH has a total of 10 faculty (specialist in Emergency Medicine) who are available to provide mentorship.

Hospital Regional de Escuintla, Escuintla, Guatemala. In a unique collaboration with the Department of Pediatrics at CMC, Emergency Medicine Faculty have developed an ultrasound training program for Escuintla's Pediatrics residents. In addition to ongoing ultrasound educational projects including "Train the trainer" courses for local pediatric attending physicians, CMC EM faculty are researching novel uses of ultrasound in low resource settings. Future goals include expanding ultrasound training to general surgery residents in Escuintla.

San Juan de Dios Hospital, Guatemala City, Guatamala. CMC EM Attending Recently secured a grant for a refurbished ultrasound machine to be donated to the new Emergency Medicine Residency Program in San Juan de Dios hospital in Guatemala City. Our department is excited to embark on a new partnership with this residency program to help expand the use of point-of-care ultrasound in their department.

 Team Rubicon, USA

David Callaway, MD, serves as the Chief Medical Officer and Medical Director for Team Rubicon (TR). In June 2018, Team Rubicon became the first US-based NGO to become certified as an Emergency Medical Team, Type I Mobile by the World Health Organization (WHO). Previous CMC fellows have been deployed to the following sudden-onset and complex humanitarian emergencies:

·       Operation Dorian Greyshirt, Abaco Islands, The Bahamas, September4th, 2019 – November 21st, 2019: Mobile medical aid operation in The Abaco Islands to support residents impacted by Hurricaine Dorian (WHO EMT Type 1 Mobile). Volunteers provided mobile medical services including triage, clinical care, and basic laboratory and pharmacy capability in hard to reach and remote areas, while hlping to monitor for and prevent disease outbreaks.

·       Operation Macuti Light, Dondo District, Mozambique, March 23, 2019-April 9th, 2019: TR deployed a team of 16 volunteers to provide mobile medical services to communities affected by Cyclone Idai.

·       Operation Latte Stone, Northern Mariana Islands, April 25, 2015 – May 22, 2015: TR launched a medical aid operation in response to Super Typhoon Yutu, where volunteers provided medical services and helped train local residents in disaster response skills to build more resilient communities.

·       Operation Hermes, Northern Greece, May 22, 2016 – January 31, 2017: TR’s longest medical operation was to provide primary medical care at a clinic in Northern Greece to help alleviate suffering and prevent further injury to Syrian and Iraqi refugees. Drs. Callaway served as a medical director throughout the operation and developed patient care protocols and procedures for the extended medical operation.