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University of the Witwatersrand EM Program, Johannesburg, South Africa

Emergency Medicine was first offered as a speciality in South Africa in 2004. Since then the program has grown and is now offered at four universities. The University of the Witwatersrand (WITS) requires the completion of 4 years as a registrar, where we rotate through other specialities and work in emergency departments at various secondary and tertiary level facilities in Gauteng. During our time at these emergency departments we gain experience under the supervision of Emergency Physicians.

We have two academic days a month during which we discuss selected topics and are rostered on the present these topics as PowerPoint presentations or practical workshops and simulations. We have a program where one division of medicine is covered each month. This month, for instance, we are covering Ophthalmology and ENT topics.
To complete the program and in order to be registered as Emergency Medicine Physicians we have to pass the primary and final examinations as set out by the Colleges of Medicine in South Africa (CMSA). We also need to complete a research project which will be assessed and will lead to a Mmed degree. Furthermore, we need to have current certificates in ACLS, ATLS and PALS and we need to gain accreditation in basic ultrasound skills.

We currently have 25 registrars in the program at WITS. Our responsibilities as registrars include teaching the medical students Basic Life Support skills and Advanced Airway skills. We also offer courses in BLS and Emergency Care to all first year paramedical students. Once a year we receive Cuban medical students who we teach Emergency Medicine skills during a two day course. We moreover volunteer to offer emergency care at large sporting events, including the Comrades marathon.

Our work environment at the public hospitals is typical for any developing country. The community desperately needs the services we offer and this leads to us seeing a vast variety of pathologies. When compared to developed countries, our public health system struggles with extreme resource constraints. This includes a shortage of staff, a shortage of hospital beds and access to technology. There is often a shortage of equipment, including consumables, blood products and medications. There is; however, also access to some very specialised treatment options. This is never enough to offer superior care to all our patients, as the needs far outweighs the access. It is often difficult to access cath-labs, theatres and even CT scanners. When taking in consideration our resource constraints, I think that we still succeed in offering superior care to our patients.

Most of our graduates remain involved in training and work in the public health system. We do not have enough graduates to run all the emergency departments at district level and this is something that the department is trying to correct. I am one of the candidates who received a bursary from the private sector to complete my studies. In return I will be working in one of the more resource limited government hospitals in South Africa. In this way we can continue educating more doctors and nurses to offer the best possible care and to practice evidence based medicine.

Several of my colleagues who have completed their degrees have made use of Roche Review and have shared their very positive experiences with the program. It has been recommended to us as a great resource to help us prepare for our final examinations. Every candidate who has purchased your programme in the past 18 months has passed their exams and are now qualified Emergency Physicians.

I have used the free trial offered and feel that it is invaluable to practice the correct format of answering multiple choice questions. I also enjoy the review and information available with each of the questions. It is an excellent way to prepare. We do not have anything similar available to us. Many of our candidates cannot afford the expense of the subscription as our remuneration is not very high and the value of the South African rand does not compare well to overseas currencies.
I am proud to be studying Emergency Medicine and to be able to give back to the community. I am very positive that Emergency Medicine in South Africa will continue to grow and that we will continue to contribute to the global community with cutting edge research and new innovations.

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