Emergency Medicine- TAAAC-EM 2016 Year in Review

This has been a remarkable year!

Many great moments, amidst great challenges. We could cite progress made in Ethiopia, as some reasons for celebration.  A fourth group of EM physicians passed their exams in Addis, keen on continuing the work many of you helped start.  A new residency program in Addis was started by former graduates.  On the broken ground of 2015 now sits, nearly complete, an “Ethiopia Centre for Excellence in Emergency Medicine.”  Still, even with these accomplishments the past 12 months aren’t necessarily ones we would want to live, exactly, again. Like any year, it seems wisest to learn what lessons it held, then let them go.

There are a few events that are less easy to say goodbye to. One is seeing one of our most stalwart supporters and guides, Cheryl Hunchak, announce that she will soon step down from TAAAC-EM to assume a role as assistant program director for the CCFP-EM program. For lack of a better-named portfolio in TAAAC-EM, she held the position of “curriculum director,” which meant she determined - with months of in-country time and dozens of dropped calls - what four generations of Ethiopian emergency physicians learned to address the needs of millions of people. Her kindness, experience, and inspiration were as rare as her resolve. All will be deeply missed.

If there are two reasons why this sad fact is easy to bear, they are these: Jennifer Bryan and Eileen Cheung. These two women, deep teachers themselves and with great ideas of their own, from  UHN and Mount Sinai respectively, will take over the role as curriculum co-directors July 1, 2017. They have an even greater task, to make the delivery of content, evaluations, and exams, an Ethiopian responsibility by 2020. We know no two people more capable of it.

While we enjoy great commitment from our community at home, the main mission of TAAAC-EM is to export, at least temporarily, the best of what Toronto has to offer. In the 2016 calendar, seven faculty physicians traveled to Addis Ababa, and three postgraduates (their names are below). Together, they delivered over 50 lectures and over 300 hours of bedside teaching. Further, almost entirely through private donations of former delegates, we supported the travel of four recently graduated physicians and five postgraduates to attend either the ICEM conference in Cape Town, or the African Federation of Emergency Medicine’s 3rd conference in Cairo, where they presented lectures and posters detailing their experience growing EM in a low-resource setting. We mentored 29 Ethiopian postgraduates directly with an experienced Toronto emergency physician and similarly supervised four newly graduated physicians to complete quality improvement projects such as, “How to prevent attrition of emergency nurses,” or needs assessments in Hawassa and Jimma, cities keen on following Addis' lead in opening ERs of their own.

What does the future hold?  Some uncertainty, sure, but a few reliable things. We will travel to Ethiopia again, should the peace hold, and graduate the fifth cohort of physician leaders. We will help cultivate the autonomy of AAU to be self-sustaining in both their scholarship and delivery of care by piloting a three-month“quality-care” fellowships in Toronto. Last, and most certainly, all of these efforts, all of this change, will continue to be borne, at least in part, by the goodwill and efforts of the community of emergency physicians at the University of Toronto

It is humbling to be in your company. It is with deep gratitude, to both our many individual donors, the ED practice plans (MSH, SMH, UHN), and the Departments of Family and Community Medicine & Medicine, who understand that the ethos of emergency medicine, where the sickest go first, is more than an idea, but a natural truth that has potential beyond the doors of our ERs. We look forward, with you, to opening them as wide as possible to people who need them most, wherever they might be.

We welcome your contributions, both your time should you want to give it (http://ghem.ca/get-involved/) (we have space in May 2017) or  your dollars (https://goo.gl/VnPr8G)  if you would like to contribute that way.  Either way, we wish you a bright New Year in person, because, as it turns out, like you, like our Ethiopian friends, we’ll be working then.

Sincerely,

James Maskalyk MD FRCP(EM) for the TAAAC-EM executive

Megan Landes MD CCFP(EM)
Cheryl Hunchak MD CCFP(EM)
Lisa Puchalski-Ritchie FRCP(EM)
David Mackinnon CCFP(EM)
Margaret Salmon FRCP(EM)

Faculty Delegates 2016:

Dominick Shelton CCFP(EM) - Sunnybrook & MacKenzie Health Natalie Wolpert FRCP(EM) - St. Michael's James Maskalyk FRCP(EM) - St. Michael’s Jennifer Bryan FRCP(EM) - UHN Julia Wytsma CCFP(EM) - Credit Valley Anna MacDonald FRCP(EM) - St. Michael's & North York General Nadia Primiani CCFP(EM) - Mount Sinai

Postgraduate Delegates 2016:

Adam Slomer
Areej Shahbaz
Dennis Cho