OBJECTIVE

To provide postgraduate training opportunity for a duration of 4 years, at the end of which will be awarded with degree of Master of Medicine in Emergeny Medicine.  Graduates emerging from this programme will be a competent Emergency Physician embracing their roles as specialists in the Emergency Department and completing external tasks that require their particular set of skills.

 

PART 1 : ACADEMIC

INTRODUCTION

This Master of Medicine in Emergency Medicine programmme is structured in such a way to provide adequate training in order to create future Emergency Physician who will be a valuable asset to the country in fulfilling their tasks in the Emergency Medicine field.

BACKGROUND AND JUSTIFICATION

The impressive advancement made in Postgraduate Teaching/Academic has led to increased need of highly skilled workforce in many specialized fields, especially in conjunction with the growing population and ever increasing healthcare standard.

• School of Medical Sciences (PPSP-Pusat Pengajian Sains Perubatan) was established in the year 1979 with the primay objective of offering a platform for Masters of Medicine programmes. In 1987, 8 years after that, School of Medical Sciences started Master of Medicine programme in Internal Medicine by recruiting 8 students in its programme. Thereafter in 1991, Master of Medicine in General Surgery, Obstetrics and Gynaecology, Paediatrics and Orthopaedic were introduced. Following that in 1992, Master Of Medicine in Pathology, in 1993 Master of Medicine in Anaesthesiology and in 1995 Master of Medicine in Radiology, Family Medicine, and Psychiatrics were started.
• The lack of trained physician in various fields throughout Malaysia was keenly felt especially at a time where the number doctors were small. There were about 2173 physicians in 1995, out of which only 988 remained in the government sector.  The need for masters of medicine program was further justified in view of the ever expanding world of medical profession.
• In conjunction with rapid growth of industries, we are seeing an increase in industrial related accidents and also natural disasters secondary to industrialization. Statistics show that in the year 1995 a total of 210 000 ase was reported and treated in Emergency Department throughout the nation. Emergency Medicine includes both pre-hospital care and hospital treatment for recovery.
• Many Malaysian Hospitals consist of Emergency Department as part of its care service, but the standard of care in this field was unsatisfactory due to lack of properly trained Emergency Physician. This in itself has directly affected the patients’ outcome leading to increased mortality rate.
• Master of Medicine in Emergency Medicine has long been established in countries such as North America, Canada, United Kingdom and also Australia. A number of Malaysian doctors has successfully completed their specialization training in the above mentioned countries and are currently employed by Universiti Malaya and also Hospital Kuala Lumpur.
• Opportunities to train in overseas have been steadily dwindling. This is due to limited training place, being too expensive, changes in the mmigration law, limited job opportunities and increased post graduate course fees.
• Medical faculties throughout the nation have been urged to offer postgraduate courses in order to improve the healthcare standard among our citizen. State of the arts equipment were introduced and this indirectly enriched the academic status among its staff. Besides, the cost of locally training medical specialists was far smaller compared to training medical specialists overseas.

 

MASTER OF MEDICINE (EMERGENCY MEDICINE) OBJECTIVES

• GENERAL OBJECTIVE

To provide training for medical officers who are interested in pursuing their studies to achieve masters in the field of Emergency Medicine. These candidates would attain sufficient skills to enable them to function as Emergency Physician providing effective and thorough clinical care for patients.

• SPECIFIC OBJECTIVES

To ensure complete knowledge and understanding of basic sciences (physiology, pathophysiology, pharmacology) and especially those pertaining to Emergency Medicine.
To ensure complete knowledge and understanding of internal medicine, paediatrics, general surgery, emergency medicine, traumatology, resuscitation, toxicology, and disaster medicine
Capable of performing clinical procedures and investigations in the field of Emergency Medicine
Capable of making the correct diagnosis quickly and precisely especially in emergency and trauma cases
Capable of stabilizing patients efficiently, confidently and promptly especially in shock patients.
Possessing good leadership qualities and passionate in sharing emergency medicine knowledge
To introduce and enhance understanding in medical ethics. Exposure on clinical disease concept and multiperspective treatment modalities
Embraces the concept of preventive medicine and possesses in depth knowledge regarding epidemiology involved in Emergency medicine
Capable of making adequate preparation and able to act rapidly in the event of disaster.
Has attained sufficient knowledge and continuously keeps abreast with current development in the field of Emergency Medicine.
Able to participate and perform research activities in the field of Emergency Medicine
Able to function as a capable emergency physician in providing emergency care which involves prehospital,  inhospital and also rehabilitation care.

 

CURRICULUM STRUCTURE

To achieve the specific objectives as mentioned above, the structure of the course is divided into 3 phases,

PHASE 1 (1^st year)                      :   Basic Sciences related to medical and surgical

                                                          Basics of Emergency Medicine and Trauma

PHASE 2 (2^nd AND 3^rd YEAR)   :  Obstetrics and Gynaecology, Paediatrics, Surgery,

                                                           Internal Medicine, ORL and Ophthalmology,

                                                           Anaesthesiology/Intensive Care, Emergency and Trauma,

                                                           Cardiopulmoary Resuscitation, Elective and dissertation

PHASE 3 (4^th year)                      :  Emergency and trauma, Elective

 

STUCTURE OF PHASE 1 CURRICULUM (1^st year)

• Phase 1 Curriculum

• Basic Sciences in Medicine and Surgical
• Basic Sciences in Emergecy Medicine and Trauma

Phase	Year	Study Field and Placement	Assessment
Phase 1	1st year	Training and Responsibilities Basic Sciences in Medicine and Surgery learned from attachment in General Medical, Paediatrics, and Surgery Basic Sciences in Emergency Medicine by working in Emergency Department	Continuous Assessment Part 1 Examination

                    

The main objective in Phase 1 is to provide basic training and to enhance understanding in the fields such as below

• Anatomy and Physiology, especially involving respiratory, cardiovascular and neurology
• Pathophysiology of diseases
• Basics in General Medicine and Surgery
• Basics of Traumatology
• Basics of Emergency Medicine
• Stabilization and Resuscitation of patients
• Pharmacology

       Candidates are required to learn and master techniques of examining patients. Candidates are also introduced to interventional concepts, stabilization of patients, airway management, resuscitation, and medical ethics.

 

PLACEMENT AND STUDY TECHNIQUES

PHASE 1 (1^st year)

In the first year candidates are expected to perform their duties in Medical Department(3 months), Paediatrics( 3 months), Surgery (3 months) and Emergency and Trauma (3 months) in Hospital Universiti Sains Malaysia, Kubang Kerian or other recognized institutions/hospitals.  Candidates will have full exposure in basic sciences in medical, surgical and also basic sciences in Emergency Medicine.

Candidates will also be required to work alongside with lecturers in performing daily duties in the specific department in order to further enhance candidates understanding and in performing examination in emergency setting

The Education Centre will prepare teaching and learning material such as audio visual, reference books, magazines and others

Emphasis will be placed on acquiring basic sciences knowledge through lectures, tutorials, demonstration, and also via performing daily tasks and procedures in the department. Learning will be done via self-study and also through constructive discussion among graduates. The topics for discussion during tutorials will be scheduled accordingly.

The Department will observe and assess through supervisors report and log books. Supervisors’ duties are as below

Examination Part 1 will be held at the end of Phase 1.

CURRICULUM STRUCTURE PHASE II ( 2^nd AND 3^rd YEAR)

PHASE	YEAR	FIELD OF STUDY AND PLACEMENT	ASSESSMENT
II	2 & 3	Training and Responsibilities *     Clinical duties in Obstetrics and Gynaecology, Radiology, Paediatrics, ORL and Ophthalmology, Surgery, Anaesthetics/ICU, Perubatan (Cardiology) & Emergency and Trauma *     Elective *     Dissertation to be started in 2nd year *     To perform duties and on call *     To be involved in research, to attend CPC and conferences *     To attend Basic Life (BL Support S), Paediatric Advance Life Support (PALS), Malaysian Trauma Life Support (MTLS).	Continued Assessment no written exam Progression from Phase II to Phase III after fulfillment of criterias as below:- 1)   Satisfactory report from supervisors 2)   To have performed research and dissertation satisfactorily 3)   To perform ward rounds satisfactorily

 

The main objective in Phase II is to expose candidates to the multitude of patients, problems, disease complication, and the most effective, rapid and precise method of treatment. Life saving surgical techniques and procedures such as chest tube insertion, management airway, stabilization of patient, cardiopulmonary resuscitation techniques  will be taught and toxicology aspects will be emphasized.

Candidates are expected to continuously enhance and broaden their understanding, involvement, and to perform acquired skills in the patients’ treatment thoroughly

To study biostatistics and medical ethic which will help in the moulding of the new generation of emergency physician who are aware of the current development.  This would enable delivery of a better, balanced and holistic treatment

Candidates will be required to perform appropriate investigations and research on certain cases to allow further understanding on disease progression as a whole and to enable gaining of experience through basics of research.

Candidates are strongly encouraged to directly involve themselves in learning programs run by School of Medical Sciences.

 

PLACEMENT AND STUDY TECHNIQUES

PHASE II ( 2^nd and 3^rd Year)

In Phase II, focus will be on learning the emergency medicine in a few associated fields ( based on medicine and surgery)

In 2^nd year, learning will be based on placement of candidates in Obtetrics nd Gynaecology ( 3 months), Radioogy ( 1month) Paediatrics ( 2 months), Neurourgery ( 3 months)  and Emergncy and Trauma Department (3 months) for the first year of Phase II. Teaching will be done via lectures, tutorial, demonstration, clinical conference, and during performance of various medical/surgical procedures. Group discussion and journal club will also be arranged.

During Emergency and Trauma placement, candidates are encouraged to attend and follow ambulance calls when responding to patients calls.

Candidates will be actively involved in seminars or potgraduate intensive course that are held in Learning Centre or other places.

In Year 3, learning of candidates will be based on placement in Anesthetics Department and Intensive Care Unit (6 months), Medicine ( Cardioogy/CCU) (3 months), ORL and Ophthalmology ( 2 months)

Elective placement of 1 month duration, which can be done in fields such as toxicology, ambulance service,  and other fields that are acknowledged by the department

Candidates must complete courses like BLS, PALS, and MTLS that are held in School of Medical Sciences and other recognized centres.

In Phase II, especially in Year 3, emphasis should be placed on self learning and able to enhance emergency medicine knowledge. Candidates should also acquire skills to perform clinical examination and procedures under the supervision of specialists. Candidates will also be expected to do on-call duties together with the lecturers.

Candidates are expected to be involved in treating emergency cases in Emergency Department in the form of oncalls or emergency calls while doing postings in other departments.

Candidates will be given particular responsibilities to be carried out by the supervisors.

Dissertation ;-

Candidates will be required to present the selected dissertation topic in early Year 2.

Once the topic has been approved, the dissertation project will be embarked on. The project would need to be completed and handed in at 6 months before the end of Year 4 which is one of the pre-requisite to sit for the Part 2 Final Year Exam.

 

CURRICULUM STRUCTURE IN PHASE III

Specialists in Training

Phase	Year	Field of Study and Placement	Assessment
III	4	Training and Responsibilities *  Clinical Duties in Emergency and Trauma Department *  Log books and course work *  To complete Advanced Cardiac Life Support Course (ACLS) *  To complete and hand in dissertation. *  To complete elective placement	Continued Assessment Part 2 Final Year Exam

 

Candidates are tasked to function as ‘Specialist in training’ and are responsible for treating patients in Emergency and Trauma Department. Candidates are encouraged to make their own decision as a specialist.

However, candidates will still be under the supervision of Specialists in Emergency and Trauma Department, Universiti Sains Malaysia or other approved institution.

Main Objective in Phase III, is to allow candidates to be exposed to more challenging and detailed  aspects  in the field of Emergency Department.  Candidates should acquire profound knowledge in making accurate diagnosis and able to carry out clinical procedures and techniques that are usually carried out.

Candidates are also expected to carry out teaching duties

Candidates are encouraged to present worksheet, research, and to attend conferences.

Candidates are to complete Advanced Cardiac Life Support (ACLS)

Candidate are expected to familiarize with administration and management problems in the Department and keep up to date with current issues for the benefit of patients’ treatment.

Elective placement for about 1 month can be carried out in fields such a  Traumatology,  Emergency Anesthesia, or other fields that are  acknowledged by the Department in the country or overseas.