Emergency medicine -- a new era in South African medicine.

The emergency medicine specialist register was opened in April 2005. This broad discipline is well defined and comprises pre-hospital and in-hospital components. It may be regarded as a multidisciplinary 'resuscitation, stabilisation, and appropriate disposition' specialty. The establishment of this new specialty is arguably the most significant development in medicine in this country for decades, providing opportunities for academics, provincial authorities and politicians to make a difference. The South African emergency physician will be different from most First-World specialists in this discipline. The conditions in our country are certainly more demanding, both in terms of work environments and the pathology profile of patients. For these reasons the 4-year training programme has been designed to suit our needs, rather than importing established First-World programmes into South Africa. We are confident that our training programmes will withstand international scrutiny and produce world-class graduate emergency physicians. Will our new graduates be expected to do a 'front room' thoracotomy? Will they be expected to thrombolyse patients in the emergency units? The answer to both is yes. The Emergency Medicine Society of South Africa (EMSSA) was responsible for establishing the specialty in our country and subsequently for founding the College of Emergency Medicine (CEM) within the Colleges of Medicine of South Africa (CMSA). The four health science faculties with departments of emergency medicine have registered MMed degrees in emergency medicine. Communication between these departments is healthy and collaboration between UCT and SU has led to a common teaching platform for the MMed programme, as well as a joint Division of Emergency Medicine. In the short time that emergency medicine registrars have been doing duty in emergency units, an increase in service levels has been acknowledged, while levels of commitment and enthusiasm have surpassed those previously demonstrated by junior staff. No doubt standards of practice and patient care in both the pre-hospital and in-hospital areas of emergency medicine will continue to improve across the country as the specialty is rolled out. What about 'grandfathering' (or to be more politically correct, 'grandparenting') individuals onto the specialist register? A consensus document has been submitted to the Health Professions Council of South Africa (HPCSA) by the CEM, EMSSA, and the university departments of emergency medicine. The objective is to offer a set of 'guidelines' to be considered when 'grandfathering' in this new discipline. The consensus criteria include postgraduate qualifications relevant to emergency medicine, a minimum of 5 years of relevant …