How to train emergency docs
===========================

* Russell D. MacDonald

I fully support the notion, expressed by James Ducharme,1 that emergency physician training through the Royal College of Physicians and Surgeons of Canada (RCPSC) specialist program and certification by the College of Family Physicians of Canada (CFPC) complement each other by virtue of the differences between the 2 educational tracks. I am the end- product of a defunct “hybrid” program combining the CFPC and RCPSC programs, which was intended to balance the principles of an in-depth academic knowledge of emergency medicine with a humanistic approach to patient care. Today, it seems that trainees must choose between these 2 aspects. I recommend that the RCPSC and the CFPC join forces to develop a single emergency medicine training program with 2 tracks: academic and clinical. Fundamental humanistic values would be instilled early in the program, through a model of primary care delivered in suitable urban, rural and remote training sites. Trainees pursuing a predominantly clinical practice would undertake a 4-year program and receive significant clinical exposure to all services and subspecialties. This would alleviate the training time constraints highlighted by Ivan Steiner.2 Trainees pursuing a predominantly academic career would undertake a 5-year program, receiving similar clinical exposure but with additional training in a specialty field of their choice (e.g., emergency medicine services, public health, education). This would formalize training in the nonclinical expertise that Ducharme mentions.1

**Russell D. MacDonald** Medical Director, Central Region Ontario Air Ambulance Base Hospital Program Toronto, Ont. 

## References

1.  1. Ducharme J. Preparing emergency physicians for the future [editorial]. CMAJ 2003;168(12): 1548-9.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY4LzEyLzE1NDgiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTY5LzUvMzg5LjMuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9) 

2.  2. Steiner IP. Emergency medicine practice and training in Canada [editorial]. CMAJ 2003; 168 (12): 1549-50.
    
    [FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czoxMToiMTY4LzEyLzE1NDkiO3M6NDoiYXRvbSI7czoyMjoiL2NtYWovMTY5LzUvMzg5LjMuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)