First year residency in Emergency Medicine in Denmark

A review of current educational programs

Forfattere

  • Lasse Paludan Bentsen Sygehus Lillebaelt, Kolding

DOI:

https://doi.org/10.7146/akut.v5i1.132160

Resumé

Background:  Emergency Medicine is the youngest Danish medical specialty, finally adopted in 2017 with the first residents enrolled in 2018. The residency consists of 1 year introduction employment with a primary residency spanning 5 years after the introduction year. The 1-year program consists of different setups of time in certain specialty areas, encompassing the primary specialties internal medicine, abdominal surgery and orthopedic surgery. The education programs can be differently structured, but with the same end qualifications for the resident. We aimed to investigate the different structures of the education programs for the 1st year residency in Emergency Medicine in Denmark.

Methods: All education programs were extracted from the three different medical educational regions in Denmark in March 2020. We reviewed all programs and the following data was extracted: Time in each primary specialty, medical courses, possibility to practice the role of team leader in critical ill patients and education in point-of-care ultrasound.
Results: 20 of 21 emergency departments in Denmark employs residents in Emergency Medicine for their 1-year introductory residency. 13 of 20 programs assess patients in internal medicine and abdominal surgery in the same time period. 7 out of 20 has pre-specified time for patients in abdominal surgery. 10 of 20 programs does not have specified time in orthopedic surgery. This is part of the internal medicine period or not specified further. Only programs in The Region of Southern Denmark have pre-specified periods for all three main specialties. 14 of 20 programs present opportunity to participate in medical courses such as Advanced Life Support. Only 3 of 20 programs present opportunity for further education in point of care ultrasound, other than the obligatory focused lung ultrasound and ultrasound guided peripheral access. 7 of 20 programs present opportunity to participate in primary assessment of critical ill patients as team leader or observer, for critical care calls.

Conclusion: The education programs in Denmark for Emergency Medicines 1st year residency varies greatly in both time in major specialties, medical courses, point-of-care ultrasound and training in the role as team leader.

Forfatterbiografi

Lasse Paludan Bentsen, Sygehus Lillebaelt, Kolding

Background: The Covid-19 pandemic have led to decreases in hospital admissions during the first period in the spring 2020, also among acute patients. However, it is not known if the pandemic had any influence on the most severely acutely ill and injured, that is patients calling the emergency number and requesting an ambulance. Prehospital data, both logistic and medical journals, are present in all of Denmark’s five health care regions, as are in-hospital data. The aim was to study hospital diagnoses and 1-and 30-days mortality among the ambulance-patient population in the North Denmark Region in 2020 compared to previous years.

Methods: This is a regional pilot study in preparation of a nationwide study, designed as a population based historic cohort study of patients calling the emergency number in North Denmark Region in 2020 compared to the years 2017-2019. Prehospital data were linked with patient administrative data on hospital diagnoses (ICD-10) and date of death. Outcomes were prevalence and mortality. Proportions were estimated using Poisson regression and proportions were compared by relative risks (RR) with 95% confidence intervals (CI).
Results: Compared with 2017-19, there were 6.5 % (95%CI 3.6;9.2) fewer patients in 2020. The proportion of hospitalizes patients increased 1% (RR 1.01, 95%CI 1.01;1.02), whereas patients not brought to a hospital decreased 5% (RR 0.95, 95%CI 0.92;0.97). Proportion of patients with respiratory diseases was reduced, from mean 2042/year to 1479 in 2020 (RR 0.76, 95%CI: 0.72;081), particularly during the first period of the Covid-19 pandemic in March-June. There was no difference for other major diagnoses, such as cardiovascular disease with mean 3046/year versus 3083 in 2020. There was no difference in over-all 1 and 1-30-day mortality in 2020 compared to 2017-19, neither for patients with nor without hospital contact, and no difference in mortality for respiratory and cardiovascular diseases.

Conclusion: In the North Denmark Region the overall number of emergency calls decreased during the Covid-19 pandemic. Respiratory diseases decreased markedly by 24% in 2020. Opposed to other studies we found no difference for cardiovascular diseases. This may be a regional pattern, and a nationwide study is needed to elucidate this.

Downloads

Publiceret

27-03-2022

Citation/Eksport

Bentsen, L. P. (2022). First year residency in Emergency Medicine in Denmark: A review of current educational programs. Dansk Tidsskrift for Akutmedicin, 5(1), 17. https://doi.org/10.7146/akut.v5i1.132160

Nummer

Årg. 5 Nr. 1 (2022): Nyt år, nye mål og nye muligheder

Sektion

Konferenceabstract

Licens

Ophavsretten deles mellem forfatter og tidsskrift.