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Indian Pediatr 2016;53:
437 |
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Training Pediatric Emergency Medicine
Specialists in India
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Indumathy Santhanam
Professor and Head, Pediatric Emergency Department,
Institute of Child Health and Hospital for Children,
Madras Medical College, Chennai, Tamil Nadu, India.
Email:
[email protected]
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I congratulate the INDO-US group for advocating the need for Pediatric
Emergency Medicine (PEM) as a super-specialty in India. The document
states that "the concept of PEM is virtually non-existent in India [1]."
I wish to share an experience that is contrary to this statement.
The 180-year-old, Madras Medical College, to which
the Institute of Child Health (ICH) is affiliated, has an annual intake
of 250 under-graduates and 54 pediatric post graduates. Established in
1997, our Pediatric Emergency Department (PED) was equipped by Japan’s
International Cooperation Agency [2]. To sustain the project, the
Tamil Nadu government sanctioned a faculty position in PEM. Over, the
next 18 years, an overwhelming number of seriously ill and injured
children were managed [3]. As septic shock was the commonest cause of
mortality, a shock protocol was tested [4]. Lessons learnt were
video-taped and conducted as the "Paediatric Emergency Medicine Course"
[5]. In 2010, our University made completion of this course compulsory
for house officers during their internship. Since 2011, a post-doctoral
fellowship course is being conducted under the auspices of the
University.
Under-five mortality due to infections is high in
developing countries and emergency care reduces mortality. Despite
significant differences in the morbidity profile of emergency visits in
India [3], the INDO-US group reports that "PED in India is not an ED in
the true sense". Denying PEM’s existence in India is self-defeating in
the pursuit of recognition of super-specialty status. Acknowledging that
academic PEM in India might be different from the US, and engaging local
expertise could help in achieving the much needed recognition for PEM
super-specialty training.
References
1. Mahajan P, Batra P, Shah B, Saha A, Galwankar S,
Aggrawal P, et al. The 2015 Academic College of Emergency Experts
in India’s INDO-US Joint Working Group white paper on Establishing an
Academic Department and Training Pediatric Emergency Medicine
Specialists in India. Indian Pediatr. 2015;52:1061-71.
2. Improvement of Medical Equipment for ICH. Ex-post
Evaluation V Evaluation by Overseas Offices. Available from:
www.jica.go.jp. Accessed January 06, 2016.
3. Santhanam I, Pai M, Kasthuri KR, Radha MM.
Mortality after admission in the pediatric emergency department: A
prospective study from a referral children’s hospital in Southern India.
Pediatr Crit Care Med. 2002;3:358-63.
4. Santhanam I, Sangareddi S, Venkataraman S, Kissoon
N, Thiruvengadamudayan V, Kasthuri RK. A prospective randomized
controlled study of two fluid regimens in the initial management of
septic shock in the emergency department. Pediatr Emerg Care.
2008;24:647-55.
5. Santhanam I. Septic shock. In: Santhanam I, editor.
Pediatric Emergency Medicine Course. 2nd ed. New Delhi: Jaypee Brothers;
2013. p. 143-57.
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