Myanmar

Diploma Course in Emergency Medicine in Yangon, Myanmar

Introduction

In Myanmar, patients often receive emergency treatment from medical providers who lack specialized training in treating emergency medical conditions. Prior to 2014, there were no trained emergency physicians in the country, and public investment in developing an emergency care workforce was nonexistent. We partnered with a private sector health institution to create an 18-month postgraduate course for practicing physicians to be trained in emergency care management and procedure skills.

Background

Myanmar has similarities with other developing nations, with traumatic injuries as the leading cause of morbidity and the third highest cause of mortality (2). A high percentage of its working population (40%) is between the ages of 15-28, and 25% of the population is under age 15 (3). Efforts to address the health quality of the young and working age population are expected to significantly affect Myanmar’s future and economic transition.

Students

  • Trainees include early-career physicians interested in Emergency Medicine, as well as mid-career MD’s who are returning for more training given their previous experience caring for patients in casualty wards in Myanmar.
  • Graduates of the program will work in the public and private sector to treat emergency patients.

Program Design

This private enterprise, a partnership model of education, is intended to limit cost and increase workforce outcomes by combining on-site visiting faculty education, procedural skills, on-line education, virtual mentorship, and local clinical exposure. By augmenting the capacity of physicians already working in Myanmar to treat urgent conditions, our hope is to increase the public’s access to trained emergency care providers and improve their health outcomes.

Curriculum

  • 18-month ‘Diploma Course in Emergency Medicine’
  • Includes all Emergency Medicine Core Topics
  • 9 distinct teaching modules
  • 2-week modules taught on-site by US- based faculty
  • Clinical Exposure
  • Leadership Training
  • Procedural Skills
  • Online Education

 

Outcomes and Evaluation

Formative Evaluations

  • Pre-Test for each module
  • Feedback on simulation case decision-making
  • Presentation skills
  • Individual student meetings
  • Leadership and Communication evaluations

 

Summative Evaluation

  • Post-Test for each module
  • Procedural Skills Testing
  • Case-Based Simulation Decision Making
  • Completion of Clinical Rotations
  • Final exam (to be coordinated with new public University training program)

Summary

Given the time intensive challenge of training new physicians, and the extent of the gap in provider coverage in Myanmar, collaboration within the private sector was explored to tackle workforce shortages. 22 physicians are scheduled to graduate from the diploma course in March 2017. This will increase the number of physicians trained in emergency medicine in Myanmar by approximately 30%. We hope to provide a scalable solution that may serve as a model for global efforts to meet low and middle-income nations’ need for emergency care providers.

Bibliography

1. A Universal Truth: No Health Without a Workforce. World Health Organization, Third Global Forum on Human Resources for Health Report, 2013.

2. Health Statistics 2012. Myanmar Ministry of Health and Sports

3. WHO Country Cooperation Strategy, Myanmar. 2014-2018.

4. Phillips, GA. Empowering clinicians to address the global challenge of trauma: an example from Myanmar. Med J Aust. Nov 16;203(190):414-5.