Physicians practicing Global Emergency Medicine (GEM) have a goal to improve worldwide health. The specialty allows them to work in a multitude of settings and clinical environments, something that no other specialty can do. Many emergency physicians specifically choose the specialty due to their desire to work internationally in low- and middle-income countries but realize that skills beyond clinical practice in an American Emergency Department are needed to become an expert in global medicine.
The UF GEM fellowship focuses on developing the fellows’ research capacity with a strong focus on research training and developing local capacity at the international sites such as building a prehospital care system or developing a mature critical care training program.
What makes the UF GEM fellowship unique?
- UF’s proximity to the Caribbean and South America
- UF’s contacts with emergency departments in other countries which is comprehensive on multiple levels—clinical, quality improvement, research and research capacity development.
- A strong focus on training of research and scholarship ability specifically in the areas of global health
- Developing specific local capacity through special projects such as ultrasound development and prehospital care systems
The UF Global Emergency Medicine Fellowship provides the expert educational tools and international experiences that can pave the way for a future career working in global emergency medicine and making a true impact worldwide.
This fellowship program functions in parallel with the existing EM residency program, as well as the fellowship programs in Critical Care Medicine (CCM), Emergency Medical Services (EMS) and Ultrasound (USN). Both clinical and research projects with a focus in these areas are possible.
The program has a strong focus on global health research, with opportunities to join existing projects or develop own projects. Formal internal and external research training is part of the core curriculum.
The global EM fellow will receive dedicated training in neglected tropical diseases, applied public health and disaster management by content matter experts at the university and through external courses.
Fellows will be appointed as post doctorate clinical associates in the Department of Emergency Medicine. They will be working approximately 768 clinical hours/year (an average of 8 shifts a month). Fellows will receive 4 weeks of vacation and an option to earn additional income.
Individuals successfully completing the fellowship program will have attained sufficient skills and knowledge to work competently as the GEM director of an academic- or community-based EM program/department.
The goal of the fellowship is to train emergency physicians to expert levels in all aspects of global emergency care, including, but not limited to:
- Clinical Competency and Expertise in GEM
- Providing clinical care in all aspects of EM in an international and resource-limited setting
- Development of clinical skills unique to the environment, including an in-depth understanding of tropical and neglected diseases with a dedicated tropical diseases lecture series
- Educational and Teaching Competency and Expertise in GEM
The program will provide fellows with the skills to be proficient educators in global emergency medicine. These include:
- Bedside teaching
- Didactic sessions
- Lectures and public speaking
- Comprehensive GEM courses
- Review articles and book chapters
- Research Competency and Expertise in GEM
Development of research skills:
- Study design
- Performing research
- Statistical analysis
- Medical writing
- Ongoing scientific discovery in GEM
- Critical analysis of the literature
- Administrative / Public Health Competency and Expertise in GEM
- Development of administrative skills
- Acquisition of specific knowledge in the aspects of GEM not related to direct patient care:
- Basic public health education through courses and classes offered at UF and other through internationally recognized programs (e.g., ICRC Health Emergencies in Large Populations course)
- Option to obtain advanced degrees, such as MPH at UF, Fellow of the Academy of Wilderness Medicine designation
- Ongoing involvement in departmental administration
- Quality assurance and improvement
- GEM program design and administration
- Interdepartmental politics
- System maintenance
- Advocacy Competency and Expertise in GEM
Dr. Torben Becker has worked in the field of GEM for almost 15 years, in various roles, including clinical care, program development, and research in countries as diverse as Greece, Ghana, Rwanda, Kenya and Haiti. In addition, Drs. Holland, Zeretzke, Abo and Elie, all faculty in the Department of Emergency Medicine, contribute additional experience and expertise in medical care in low-resource environments, with a particular focus on Haiti, prehospital care and pediatric emergency medicine. These faculty have a combined experience of over 40 years in the field of GEM.
The Department of Emergency Medicine has several established international partner sites with opportunities for clinical work, education and research. Our program’s focus is currently on partners in West Africa and the Caribbean.
Global Emergency Medicine Fellows will spend 12 months at our international partner sites International work will include clinical activities, teaching and research. All travel is paid for by UF. The program includes paid attendance at the ICRC HELP Course in Baltimore or Geneva, Switzerland (application required).
Sample Curriculum Plan
Training in cultural awareness, ethics of practice in low- and middle-income countries
International rotation #1 (two weeks)
Purpose: Identify fellowship project at international site and develop fellowship project proposal
Tropical Medicine lecture series
Vacation (one week)
Purpose: Field-specific knowledge acquisition and regulatory compliance for fellowship project
- October International rotation #2 (two weeks)
Purpose: Fellowship project implementation
International rotation #3 (two weeks)
Vacation (two weeks)
International rotation #4 (1 week)
Purpose: Fellowship project follow-up #1
Health Emergencies in Large Populations course in Baltimore (two weeks – alternative: June course in Geneva)
Purpose: Internationally recognized course in applied public health in disaster and low-resource settings
International rotation #5 (two weeks)
Purpose: Fellowship project follow-up #2
International rotation #6 (two weeks)
Purpose: Fellowship project wrap-up
International rotation #7 (one week)
Purpose: Fellowship project completion
Attend Global Emergency Medicine Academy at Society of Academic Emergency Medicine Annual Meeting
Vacation (one week) Networking
Purpose: Presentation of fellowship project results
Completion of clinical hours
Purpose: Completion of outstanding tasks
Completion of the fellowship will also provide the individual with the requisite academic skills to be an effective researcher and teacher in the field of GEM. Most graduates of a GEM fellowship program work in academic medicine, but some also practice in a community medicine environment.
Direct Clinical Care
There is a growing recognition that expertise in the management of traumatic injuries and non-communicable diseases are a growing need in the resource-limited environments. Many physicians who have worked in countries with low resources have found that their ability to think creatively and improvise solutions and take care of critically ill patients are much improved by working overseas. Additionally, GEM physicians contribute to building capacity in the local community.
Training of local clinicians is keys to creating a sustainable improvement in care. Opportunities exist to provide longitudinal training to prehospital clinicians, nurses, and more.
Working in disaster settings is extremely challenging but equally rewarding, as skills are put to optimal use. Many EM physicians are on the rosters of aid organizations and are called upon when disaster situations occur. Typically, these physicians are called upon on short notice to provide care at often remote areas of the world.
Large investments are frequently made both in time and money to improve health care systems in low-and-middle-income countries. Physicians are called upon to measure outcomes of different interventions and improve upon mistakes in the system. Local involvement provided in the GEM fellowship program allows physicians to understand the gaps and needs in an area leading to future research.
A good healthcare system requires more than just clinicians, but resources like also need buildings, electricity, clean water, and secure facilities. International emergency departments may have point of care ultrasound but lack essentials like gloves, or a video laryngoscopy system but no blades. There is tremendous work to be done in creating the systems that will allow patients, clinicians, and trainees to succeed.
The UF Global Emergency Medicine Fellowship will provide the expert educational tools and international experiences that can pave the way for a future career working in global emergency medicine and making a true impact worldwide.
Inquiries, questions and applications can be directed to Dr. Torben Becker at email@example.com. Applications should include two letters of recommendation (one from the resident program director if currently a resident), the applicant’s CV and a personal statement (not to exceed one page).