DM Emergency Medicine

4-8 year programme               July    

The Emergency Medicine Unit within the Department of Clinical Surgical Sciences provides a DM in Emergency Medicine, which is a four (4) year full-time residency training program in the field of Emergency Medicine. The University of the West Indies (UWI) has been offering the D.M. Emergency Medicine programme since 1990. The programme was first established in Barbados in 1990. In 1997, largely thanks to the contributions of Professor Archibald McDonald, the programme was made accessible at the Mona campus.

Rotations

Six (6) months each year is spent in emergency room rotations. The other six (6) months are spent rotating through relevant subspecialty areas including: Anaesthetics and ICU, Paediatric Emergency (6 months), Internal Medicine, Surgery, Orthopaedics, Community, Obstetrics and Gynaecology and Psychiatry.

Grand Rounds

Residents are also expected to participate in and attend monthly Emergency Medicine Grand Rounds. A chief resident is assigned to organise each grand rounds session. The presentation should be prepared and presented to the consultants two weeks before the actual grand round presentation.

Teaching Methods

Teaching will be conducted through the following methods:

a) Classroom sessions in eight (8) modules                          b) Bed side teaching

c) Grand rounds                                                                   d) Pod casts

e) Short courses for practical skills                                       f) Journal reviews

g) Scenario practice and mini conferences                            h) Clinic sub-specialty sessions

Assessment

Assessment will be through a combination of module assignments (Module assignments will concentrate on the development of protocols and guidelines relevant to each module, using up to date evidence), tutorials (prepared by the students and presented to the class) clinical logbooks, and examinations. Logbooks and portfolios or diaries of care will consist of clinical cases and critical incidents (both clinical and non-clinical) encountered by students during their training, with a reflection on the relevance of the incident, and how it has changed the student’s practice of Emergency Medicine. Feedback is given from the supervisors that are assigned to each student and from residents during modules. Mock and short examinations are carried out as well as appraisals are done every three (3) to six (6) months (within and out of rotations). 

The Case Book

In addition, a book must be prepared over the four-year residency period consisting of ten (10) case discussions and a research project. This casebook must be completed (Five cases before the Part I Examination) and submitted 6 months before final exams. Failure to submit the casebook/research project by the stated deadlines automatically eliminates the candidate for the exam period in question.

 Requirements for Entry

The requirements for entry are:

a) MBBS from accredited medical school                                                         

b) Full medical board registration

c) At least one (1) year experience in an Emergency Department                     

d) Must be presently working in an Emergency Department in one of the main hospitals;

e) Previous resuscitation courses are recommended (ACLS, APLS, ATLS)

Final Examinations

Part I DM

Candidates will be eligible to sit the Part I examination upon completion of five (5) cases within two years but not greater than four years after the entry into the programme. This examination is designed to test the knowledge, attitudes and skills of residents at the end of their second year of the DM programme. It is expected that candidates will have completed studying all sections of the syllabus by the end of their second year, in preparation for the Part I examination.The syllabus is divided onto five sections:

I. Anatomy                 IV. Pharmacology 

II. Physiology              V. Principles of Emergency Care

III. Pathology

The examination will consist of a written, clinical and oral examination as follows:

Written Examination

This will consist of two papers:

a) MCQ: consisting of 120 questions and covering all five (5) sections of the syllabus. The paper may include questions in the ‘single best answer’ format as well as extended matching questions. There will be no negative marking for this paper. (Time allotted: 3 hours). 

b) Data Interpretation: consisting of 30 questions, each containing a piece of clinical data (including, but not limited to, x-rays, CT and MRI scans, blood results, ECGs and clinical photographs), followed by a series of short questions pertaining to the data presented. Questions may relate to direct clinical interpretation of data, or application of basic sciences principles related to the data (for example, an x-ray of a fractured humeral shaft may be followed by questions on the neurological deficits expected with injury to the radial nerve) (Time allotted: 3 hours). 

The Clinical Examination

The clinical examination will be in the form of an Objective Structured Clinical Examination (OSCE), consisting of 10 stations. This examination is designed primarily to assess the knowledge of candidates with regard to their clinical knowledge and skills pertinent to their level of training. Specifically, the subject matter will largely reflect the curriculum of the ‘Principles of Emergency Medicine’ section of the Part I curriculum. (Time allocated: 12 minutes per station). 

The Oral Examination

The oral examination will cover all sections of the Part I course during which clinical scenarios, radiological investigations, electrocardiograms and equipment may be presented to the candidate as a starting point for discussion Candidates will be examined by a panel of examiners for 10 minutes each. At the end, the examiners will agree an overall mark for the candidate based on the following criteria: factual knowledge; ability to reason and think critically; ability to apply basic science knowledge to clinical scenarios and communication skills. (Time allotted: 60 minutes). 

Part II DM

Candidates will be eligible to sit the part II examination two (2) years, but not greater than four (4) years after successful completion of the Part I examination. The Part II examination consists of the following components: 

a) The written paper (Modified essays)                                         b) Clinical Examination (Long cases and Short cases/ OSCE)

c) Oral Examination (Clinical and Non-clinical situations)             d) Defence of the Case Book/Research Project