Carolinas Medical Center - Global Emergency Medicine

https://atriumhealth.org/education/graduate-medical-education/physician-fello...

The Department of Emergency Medicine at Carolinas Medical Center has a strong commitment to expanding emergency care for the sick and wounded globally. Our global emergency medicine (GEM) program operates under the mission of capacity and resilience building and international crisis response. 

As part of these efforts, we launched a Global EM fellowship in July 2018, and graduated our first fellow in June 2019. Since 2009, our department has enjoyed a productive clinical and research capacity-building relationship with the Muhimbili National Hospital (MNH) and the Muhimbili University of Health and Allied Sciences (MUHAS). The tangible products of this collaboration include the development of the MNH ED and the emergency medicine residency program at MUHAS. Both the ED and the residency program are the first of their kind in Tanzania and both are now staffed and run by locally-trained emergency physicians and nurses. To date, the research products of our inter-institutional collaboration have included 16 scientific abstract presentations (14 by a Tanzanian investigator) and 8 full-length peer-reviewed publications (5 with a Tanzanian first author and all with a Tanzanian second author). 

Our approach to this partnership has focused on sustainability and so all our research and educational activities are aimed at building local capacity. The emergency care in Tanzania is led by the Emergency Medical Association of Tanzania (EMAT). The Department of Emergency Medicine also has a partnership with the disaster response, non-profit organization, Team Rubicon, with medical direction being provided by the Department of Emergency Medicine at CMC. 70% of Team Rubicon’s 75,000 volunteers are military veterans, allowing the organization to respond quickly and efficiently to disaster areas in the United States and internationally. Pairing the skills of military veterans with first responders and emergency medical personnel Team Rubicon can respond to international disaster responses. The GEM fellowship is a 12 – 24-month fellowship, with a Master of Public Health degree from University of North Carolina, Gillings School of Public Health option for the 24-month fellowship.







Clinical Sites

Carolinas Medical Center Main, Charlotte, North Carolina Carolinas Medical Center 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. As of November 2007 Levine Children's Hospital opened with 234 beds. Residency programs exist in all specialties including Emergency Medicine. The Emergency Medicine Residency is a PGY 1-3 program that includes 42 residents. Fellowship positions are offered in EMS, Toxicology, Ultrasound, Pediatric Emergency Medicine, and Research. There are 38 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. There four treatment areas: Major Treatment, Diagnostic Center, Ambulatory Emergency Center, and a 12-bed Children's ED. Patients are triaged to one of these four areas based on the acuity of illness. The Children's ED is first in the region that offers 24-hour emergency care for children in a family-centered environment. Three to five board-certified emergency medicine faculty members are present in the open areas 24-hours a day. Within the department is a satellite radiology suite. Additional features include digital X-ray, computerized labs and transcriptions, point-of-care testing, and wireless networking. 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. Emergency Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania The ED volume per day is 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. The fellow will become licensed to practice medicine 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. Team Rubicon, USA Dr. David Callaway, CMC Faculty, serves as the Chief Medical Officer and Medical Director for Team Rubicon (TR), an international disaster response nonprofit organization. In June 2018, TR because the first US-based NGO to receive World Health Organization (WHO) verification as an Emergency Medical Team (EMT) Type 1 Mobile. Previous international disaster responses include: • Operation Macuti Light, Dondo District, Mozambique, March 23rd - Ongoing – TR deployed a team of 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 Tenzing, Kathmandu Nepal, April 25, 2015 – May 22, 2015 – TR deployed a medical team to aid the Nepalese people. • Operation Condor Flight, Ecuador, April 21, 2016 – May 1, 2016 – TR deployed a damage assessment and mobile medical team to support those affected by the 7.8 earthquake that struck the country’s central coast. • 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 and Noste served as medical directors throughout the operation and developed patient care protocols and procedures for the extended medical operation. • Hurricane Maria, Dominica, September 26, 2017 – Team Rubicon was requested to send an Emergency Medical Team, Type 1 Mobile team to the island of Dominica by the Pan American Health Organization (PAHO).




Fellowship Curriculum Outline

Clinical Care Average 12 hours/week clinical responsibility over the academic year for 49 weeks with 2 weeks of vacation and 1 week of CME. The clinical responsibility will be blocked to allow for longer international experiences. Education Theme Blocks 1. Travel and Field Medicine 2. Humanitarian Relief 3. Disaster Management 4. EM Systems and Development 5. Public Health 6. Program Administration 7. Academic Skills Fellow Didactics - will be on Tuesdays when the fellow is in Charlotte. Journal Clubs - will be every 3 months and organized by the fellow. Courses 1. Choice of Humanitarian Emergencies in Large Populations (HELP) vs. Harvard Humanitarian Initiative Course 2. Global Health Intensive Course at CMC 3. Additional CME funding available for domestic conference of fellow's choosing. Electives/International Experience 1. Muhimbili National Hospital Emergency Department, Dar es Salaam, Tanzania, 3 months 2. Escuintla Hospital, Escuintla, Guatemala, 2 weeks of optional projects in ultrasound education 3. Team Rubicon USA, International medical disaster response, 2 - week disaster response rotations when organization is responding to international disaster




Alumni




Application

Application Process

To apply, please email a copy of the following documents to adeline.dozois@atriumhealth.org (Fellowship Director), cc: mary.fiorillo @atriumhealth.org (Fellowship Administrator) 1. CV 2. Personal statement: including interest in our program, experience, and goals 3. 2 letters of reference




Contacts

Program Director
Adeline Dozois

Director of Global Emergency Medicine at Carolinas Medical Center. Dr. Dozois has experience working in diverse settings across Africa, South Ameri...

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Important Dates

Application Deadline | 2019-10-01

| 2019-10-28

Offer Date | 2019-11-12



Projects

Project Name & Description Details