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University Teaching Hospital of Kigali, Rwanda

The Emergency Medicine & Critical Care Residency Program (EMCC) at the University Teaching Hospital of Kigali (KUTH) was established in October 2013 as part of a multinational collaborative effort called Human Resources for Health. The program began accepting and training applicants in August 2015 with the first cohort of graduates in 2019. The program is a joint effort between the University of Rwanda and the Ministry of Health. Trainees are primarily based at KUTH. However, in recent years, trainees have had rotations at King Faisal Hospital and the University Teaching Hospital of Butare (BUTH).

The University Teaching Hospital of Kigali (KUTH) is a public institution providing care to patients across Kigali, the largest metropolitan area in Rwanda. KUTH serves as the largest referral hospital in Rwanda with 519 beds. The hospital opened its doors in 1928 as a health center and transitioned to a working hospital in 1965. Today, KUTH is home to multiple specialty services including Orthopedics, Urology, Neurosurgery, Otolaryngology, and Obstetrics/Gynecology. EM Resident Physicians have the opportunity to treat a wide array of pathology.

The EM Residency Program provides a challenging working environment for trainees. The KUTH Emergency Department faces many of the obstacles commonly seen in emergency medicine among LMIC countries, including underfunding and limited resources. Residents are given experience working in a high-stress large hospital system. As the largest referral hospital, the KUTH ED receives critical patients from district hospitals across the country. For this reason, EM Residents are forced to provide care to critical patients at a high volume with limited staff and beds.

The program has limited resources to support clinical training. All training materials, including textbooks and question banks, are provided through free open-access resources. The program also has limited trainers, relying heavily on visiting faculty and former program alumni who volunteer their time weekly to provide didactic training.

Despite restricted funding and resources, the EM Residency Program has transformed emergency medicine in Rwanda. In a study conducted by Brown University to evaluate the efficacy of the program, results found an association between the implementation of EM training with formalized EM care systems and a reduced overall hospital mortality, driven predominately by improved EC survival (Aluisio, et al., 2019).

To date, a total of four cohorts have completed the EM residency-training program with a total of 18 graduates. These graduates have gone on to work in hospital systems across Rwanda, including King Faisal Hospital, the University Teaching Hospital of Butare, and the Rwanda Military Hospital. The program has built a strong alumni community with several graduates staying in the KUTH ED after the program, going on to become leaders in the department and mentors to future cohorts.

The Rosh Review will be a transformative asset to the program. As a whole, Rosh Review will elevate and enrich the clinical training provided, allowing Residents for the first time to have access to a dynamic question bank. Rosh Review will be essential in filling the program’s current gap in education due to limited trainers. Faculty will be able to lead clinical trainings in- person and then direct residents to Rosh Review to expand on that knowledge, a component that the program has never had before. With Rosh Review, the EM residency-training program will ensure its residents are receiving the highest quality education.

On a personal level, Rosh Review will provide residents with the resources to study efficiently and effectively. This will be crucial, as extensive studying alongside high-stress days in the ED, has led to feelings of burnout among residents. However, with a systematic means of studying with Rosh Review, this stress will be reduced. Residents currently only utilize open public access study tools. With Rosh Review, for the first time, residents will have an individualized study experience with personal analytics and online support.

As a program operating in an LMIC, Rosh Review will be imperative to providing equitable opportunities for education and in turn, improving emergency medicine in Rwanda.

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