Improving Access to Emergency Care in Colombia

Jeffrey Chen, M.D.
Resident in Emergency Medicine at MGH/BWH
PGY 2

February 6, 2019

Emergency medicine was first recognized as a specialty in Colombia in 2005. Since then, there have been 7 EM residencies founded throughout the country. Many of these EM-trained providers stay in urban hospitals. However, in Colombia and many other Latin American countries, there is a huge gap between care in densely-populated cities and rural areas.

Rather than the system here in the US, where medical students typically start residency straight after medical school, in Colombia, graduates freshly out of medical school perform a year of Servicio Social Obligatorio (SSO) where they are placed in rural sites. These hospitals are often less well-staffed and have far fewer resources than are available in urban hospitals.

One of my goals in going to Colombia was to help evaluate the knowledge and level of comfort of last-year medical students with the management of emergency conditions – just before they are sent off to practice on their own or with relatively less supervision in these rural areas with more vulnerable patient populations. This is for the preparation of the rollout of the Basic Emergency Care Course developed by the World Health Organization, which teaches knowledge and skills like airway management, resuscitation of shock, trauma evaluation and care, and other fundamental life-saving skills.

Working with emergency medicine residents and medical students to improve our survey regarding comfort and knowledge with emergency medical conditions.

Another project I’m helping out with here is with the Harvard Humanitarian Initiative. In 2016, Colombia ended a decades-long conflict between the government, paramilitary, and guerrilla groups. In my time here already, I’ve met many healthcare professionals who had stories about how this conflict affected their medical and nursing education as well as their ability to provide good care. Stories of different armed groups coming to hospitals were not uncommon, as well as changes both positive and negative made to the curricula as a result of these conflicts. These were especially common in rural areas, and many of the doctors I’ve met have surmounted incredible challenges in the past.

Being involved in these academic projects has been inspirational. To meet so many people here in Colombia working to improve the healthcare system and access to emergency care is incredible. I look forward to watching this evolution.