Collaboration On Emergency Medicine In Ghana

A 2010 pilot grant from the National Institutes of Health Fogarty International Center allows the Department of Emergency Medicine at U-M and the Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana, to move forward with their collaborative effort to develop a postgraduate training program in Emergency Medicine.  The grant, which is part of the Medical Education Partnership Initiative (MEPI), provides support for U-M faculty to spend time at the Komfo Anokye Teaching Hospital (KATH) in Kumasi to train emergency medicine providers, including nursing staff. 

During an initial visit to U-M, the Rector of the Ghanaian College of Physicians and Surgeons, along with various medical and public health delegates, met with leadership from the Department of Emergency Medicine.  Their discussions highlighted the need for emergency medicine (EM) in Ghana and addressed the question of the specific role for U-M as Ghanaian institutions identified EM priorities.  Subsequent visits to Ghana (in 2008 and 2009) and ongoing communication with various partners led to the creation of a partnership, the Ghana Emergency Medicine Collaborative.  Besides U-M’s Department of Emergency Medicine, this partnership includes KATH, KNUST, the Ghanaian College of Physicians and Surgeons (GCPS), Ghana’s Ministry of Health, and the University of Utah Section of Emergency Medicine, whose faculty had also been exploring ways to partner with Ghanaian colleagues. 

The goal of the Ghana Emergency Medicine Collaborative is to improve the provision and outcomes of emergency care in Ghana by developing the training in and practice of EM in Ghana.  In order to be accredited by the GCPS—and thus train physicians in a specialty recognized by the Ghanaian government—the Ghana Emergency Medicine Collaborative submitted to their Ghanaian partners an outline of an EM curriculum drawn from standards set by the World Health Organization as well as input from British emergency medicine physicians of Ghanaian heritage and the U.S.-based Accreditation Council for Graduate Medical Education in Emergency Medicine.  The curriculum was submitted to the GCPS for accreditation, with the understanding that the initial curriculum will undergo frequent review and refinement to create a truly country-specific curriculum and thus training program.

The first-ever EM residency in Ghana was offered to newly qualified physicians starting in October 2009, when the curriculum was accredited.  The first class consisted of seven residents, who were selected through an interview process conducted by two U.K.-trained EM physicians of Ghanaian heritage with the assistance of two members of the Ghana Emergency Medicine Collaborative.  The second class, also of seven students, began their training at the KATH hospital in September 2010, while a third class of four commenced their residencies in 2011.  In Ghana, young doctors finish medical school and then complete two years as “house officers,” during which time they rotate for six-month blocks in each of four specialties: general medicine, surgery, pediatrics, and obstetrics and gynecology.  With the graduation of the first class of in-country EM physicians in 2012, there will be a fifth option, Emergency Medicine, which will be open to at least some “house officers.”  Furthermore, there are plans to expand the specialty of Emergency Medicine to other regions in Ghana once the first class graduates.  With the support of colleagues at KATH and U-M, these graduates will establish departments of Emergency Medicine at other hospitals so that eventually the entire country is served by specialty-trained physicians and nurses.