doctorjackofalltrades

[doctorjackofalltrades]

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Why Emergency Medicine?

For as long as i can remember, I never mentioned when I was a kid that I want to become a doctor. I want to become an architect and draft many beautiful skylines and skyscrapers. Yet until I played doctor to my siblings when they got ill. Sometimes, I watch science and doctor shows, and wish to become older so I can do the same. Even when I was skeptical about different aspect about my life, I am absolutely certain that I am bound to do things that would really help people.

Fast Forward

2017

I finished my Medschool at San Beda University College of Medicine. I yearned to take Specialization in Neurology after Internship Program and passing the Board Examination. Stroke is inherent in my maternal as such there's no question that I want to become a Neurologist. Moving forward to Clerkship (4th year Medical school), I was unveiled to vast array of case scenarios-- spattered blood, stabbed wounds, heart attack, patients who are dead on arrival, and all those horror stories. Most of them are emergency and urgent cases that really needs quick decision. It was a battlefield within a hospital, a chaotic emergency room with problems in understaffing and lacking of resources. I wasn’t aware at this time that EM had developed into a medical specialty other than mainstream specialties like Pediatrics, Surgery, and Internal Medicine.

2018

I had my Internship Program at Philippine General Hospital which exposed me to more grave and rare diseases. Never in my life I imagined handling those cases- Steven johnsons, Family of ichthyosis, SLE, X linked dystonia of Panay and many more. I loved Emergency medicine even more, now that I experienced emergency sections of different specializations. All needs were maximized and hope was still provided even when others has given up.

2019

The second part of our Physician Licensure examination (PLE) was delayed for a month due to typhoon. That gave us less days to prepare for Preresidency Program (Emergency Medicine).

Just 2 days before our second part of PLE. Around 10ish in the morning, I was on my second jeepney ride going to my school for Board Exam review. At the terminal along Recto, a commotion broke along the street. Someone yelled that a person was seen unconscious in the middle of the alley. So I hurriedly went down and asked some questions to those who have seen the man before being unconscious. I checked for consciousness as if i was on a Basic Life Support Training Revalida. I tapped the man and said "Hey, ayos ka lang ba" (Hey, Hey, are you alright?)." but to no response. I checked the pulse, and gladly there was but thready. One of the bystanders said that the person was known to them as a vagrant having seizure episode every now and then. I placed the patient on his lateral side to prevent aspiration because i saw drooling from his mouth. Less than a minute passed, the man regained his consciousness but without memory of the event. He hurriedly wanted to stand up but I insisted and asked him to rest.

"Wala pa po akong kinakain simula kahapon, meron ba kayong pagkain? ( I haven't eaten anything since yesterday)", as verbalized by the man. The street vendor gave him about 2 sticks of banana cue. The other one gave him water. The universe was trying to set me up with this one. The subconscious in me, "This is It!, I want to be an Emergency Physician.."

December 18, 2019

My bornday and the same date I took my oath as a Physician to the Nation. There I speak the Hippocratic Oath, "To preserve the finest traditions in my calling and may I long experience the joy of healing those whe seek my help".

"One day, you'll be at the place you always wanted to be."

No one told me that this journey was going to be this hard but also none has told be that this will be that easy. Before I got into this dream being a reality, I had tons of coffee, sleepless nights, ditched every friends social gatherings, shed every blood, sweat and tears. I am glad that I am at this place and made it a reality.

[doctorjackofalltrades]

Jack of all trades, Master of none.

Emergency medicine (EM) is the specialty that evolved out of necessity in recognizing, evaluating and treating of patients who are acutely ill or injured. It is a high-pressure, fast-paced and diverse specialty that requires a broad base of medical knowledge and a variety of sharpened clinical and technical skills. Emergency physicians treat all age groups in a multitude of conditions with varying magnitude of severity. Everyday is like no other and unpredictable, and a daily story as an EM doctor is quite full of unforseen obstacles. The training requires prowess on vast areas of specialties along with passion and heart for caring. It is a privilege to take care of the patients in their most vulnerable time of their lives. It takes honor in taking care of the people who cannot care for themselves. The thrill of saving a patient from 6 feet underground brings indescribable feeling and beyond words to express. Bringing the chaos of the Emergency Department into order is what sets them apart. It requires acuity in decision making without the benefit of complete history and physical examination.

EM as an independent specialty is at its infantry as compared to other specialties. Hospital emergency departments (EDs) were usually manned by physicians or senior house officers (SHOs) on a rotation basis, of which among them are Internal Medicine, Family Medicine, and General surgeons. There’s so much liberty in the the practice of EM compared to others like surgeons who in the middle of the night need to wake up and take a call about emergency procedures or internists who need to telephone an order for change in antibiotics of their patient.

EM dates only dates back to 50 years, making it one of the youngest recognized specialty in the medical field. EM was not pushed into a specialty status until the establishment of American College of Emergency Physicians (ACEP) with a votation from the American Board of Medical Specialties. The first emergency medicine residency program in the world was begun in 1970 at the University of Cincinnati and the first Department of Emergency Medicine at a US medical school was founded in 1971 at the University of Southern California. It is rapidly expanding in multiple directions, breaking through the walls of the hospitals, heading to the very important elements of all other medical specialties. Sub-specialties of emergency medicine includes toxicology, pediatric emergency medicine, prehospital, disasters, trauma, critical care, hyperbaric medicine, administration/practice management and research, forensic, ultrasound, wilderness, and sports.

EM in the Philippines

Listed as 7th among the most in demand doctor specialties in the Philippines according to InsiderMonkey.com. EM is still in its infantry, in May 1988, a group of Makati Medical Center doctors organized the Philippine College of Emergency Medicine and Acute Care Inc. Its objectives are to assure the quality of emergency care, to protect the welfare and professional interests of emergency physicians and to coordinate education in the specialty--Sinon & Peralta. It was only established as a specialization in the Philippines in the year 1991. The Philippine College of Emergency Medicine, the specialty organization of emergency medicine physicians is now recognized by the Philippine Medical Association (PMA)

Currently, there are 20 Emergency Residency Training Programs in the Philippines. Of which follows different structures such as Emergency Severity Index (ESI), and Australasian Triaging System (ATS). Each program also follows a three year or four year training which includes diverse areas of Emergency Medicine. Emergency Specialists acquire Fellowship after continuous engagement of practice in Emergency Medicine. EM has become one of the most competitive specialties in our country producing less than 50 graduates per year.