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There are now three societies that link emergency medicine
interests in Chile. Each society covers a specific aspect of
emergency medicine.
1. SOCHIMI:
Sociedad Chilena de Medicina Intensiva which
represents the critical care aspects of emergency care.
Some of the early champions of emergency medicine in the
1990s had ties or indeed their origins in critical care. Most
notably, José Miguel Mardonez, MD (considered a father of
modern EM in Chile) started his career in critical care.
2. SOCHIPRED:
Sociedad Chilena de Medicina Prehos-
pitalaria y Desastres which represents the prehospital
care aspects of EM including mass casualty and disaster
response. Ambulance personnel, paramedics, physicians,
and SAMU system directors are represented in this group.
3. SOCHIMU:
Sociedad de Chilena Medicina Urgencias is
the newest of the three and represents the core of EM clin-
ical practitioners. This group eventually presented Chilean
EM interests to the International Federation of Emergency
Medicine (IFEM) and Chile is now an Associate Full Member
of IFEM. The development of EM in Chile with entrance to
IFEM occurred at a relatively rapid pace and places Chile in
the position of a leader in South America.
Challenges remain for these 3 groups, and they are yet to have
a large combined meeting, and the groups are not cohesive or
particularly politically active. Membership is fragile in SOCHIMU
and if new graduates and trainees do not join, this critical
organizational unit could be lost. The leadership of SOCHIMU
must be able to represent the entire group and avoid local
partisan behavior or favoritism toward any particular interest
to succeed and continue to grow. SOCHIMU must also work
within the Chilean house of medicine (and the academics) to
create a board examination, determine how to close the “prac-
tice track”, and how to represent not just the interests of the
physician members but also the patients they serve effectively.
EDUCATIONAL MEETINGS WITH AN EM FOCUS
The American College of Emergency Physicians (ACEP)
country report for Chile (last updated in 2015) lists
numerous educational activities happening within Chile
that pertain directly to EM training and expertise (14). These
help foster cohesion, serve to enhance the interest in EM
and allow opportunity for more international collaboration.
Below (Table 1) is a partial list of the higher profile educa-
tional offerings in which have happened in Chile and several
are annual events like “Conceptos”. The educational activi-
ties reflect a vibrant community with academic, administra-
tive, and procedural considerations. Specific epidemiologic
concerns of national interest like geriatric emergencies and
trauma care are represented in content clearly developed
specifically for Chile.
While Advanced Trauma Life Support (ATLS), Pediatric
Advanced Life Support (PALS) and Advanced Cardiac Life
Support (ACLS) have all been offered in Chile, the current
training programs in Emergency Medicine do not empha-
size these short courses.
There is a Chilean Chapter of the American College of Surgeons
and in 2016 this chapter celebrated “30 years of ATLS” in Chile.
ATLS training by the Chilean chapter has included both student
and instructor courses in Chile and in the surrounding coun-
tries. In Chile 7582 physicians have done this course.
CONCLUSIONS AND FUTURE CHALLENGES
Emergency medicine has had a successful and rapid develop-
ment in Chile. The new specialty is ideally suited to improve
initial hospital care, diagnostics, and transitions to inpatient
Chilean medical, surgical, and critical care services. Chile is
now a leading nation and example for South America and
no other country in the region has 10 training programs.
The currently existing EM residencies in Chile (of variable
academic quality) host approximately 150 resident trainees
in EM and are now self-sustaining and supported by the
MOH. The first goal of these programs is to get clinically
competent trained EPs into many of the larger hospitals
across the country starting with the urban centers (both
public and private). The new graduates are the pioneers of
the specialty and must work to meet the emergency care
needs of the country. A list of some of the specific challenges
ahead for EM in Chile. Lessons learned from EM development
in other countries development struggles are emphasized in
an article from Arnold JL, et al (15). A summary is as follows:
1.
Quickly expand to meet the clinical needs of the of the
acutely ill Chilean patient population, and remain focused
on this goal. Adding value from the public health and the
patient’s perspective will be critical to long term emergency
medicine success (16).
2.
Strengthen the existing EM residency training programs
so that the training offered is as comprehensive as possible,
and has less variability from program to program. Strength-
ening the existing programs and expanding them should
be a higher priority than creating additional new programs
because currently there are not enough trained faculty to
lead additional high quality training programs.
[THE SPECIALTY OF EMERGENCY MEDICINE IN CHILE: 20 YEARS OF HISTORY - Mallon WK MD et al]