I observed that people are afraid of working in the A&E department all over Pakistan. The same is suggested for other countries, but I want to know the opinion of doctors working personally in A&E, or having work experience in the same. Moreover I am looking for published or unpublished case control studies about this topic.
Dear Maroof,
It’s essential to ask that question but there are two views to this issue.
1st, in Pakistan the formal residency/postgraduate medical training in Emergency Medicine is in its evolutionary stage. CPSP has only recently accredited only a few institutes in the entire country for training. They themselves are training to send people out of the country. http://www.pulsepakistan.com/index.php/main-news-may-01-13/314-cpsp-trying-to-promote-emergency-medicine-by-organizing-training-of-postgraduates-in-ireland
2nd is the issue of resources and demand. Your teaching hospital is affiliated with Lady Reading Hospital. How many cases come to the ER there? How has the local law and order situation changed this number in recent years? After SELF-studying through public sector medical schools many students don’t want to end up mentally-traumatized, by having to treat trauma patients without proper resources. Unfortunately, they want to earn to support their families and remove themselves from such potential land mine areas. Exceptionally few want to stay back and work with whatever they have in hand. Khyber Medical has got 8000+ graduates. Where are they practicing now? It’s the same story everywhere.
Even globally, ER has been documented a stressful area to work in. A few interesting readings are ‘Factors associated with stress among emergency medicine residents’ by Theodore W Whitley. Also, ‘A year in transition: a qualitative study examining the trajectory of first year residents’ well-being,’ by Christopher Hurst.
I recommend the reading the article by Shanafelt TD.
Arch Intern Med. 2012 Oct 8;172(18):1377-85. Burnout and satisfaction with work-life balance among US physicians relative to the general US population.
More stressed but satisfied, it's my opinion about myself !!!
To answer this question should pay attention to lots of aspects such as background mood, financial state, weekly time spend in ED, nutrition, marriage state and even socioeconomic state of the referred patients.
I'm going to conduct a study about anxiety and depression disorder incidence among emergency nursing staff, in future month that may answer better after that.
Hi, I am an Emergency Medicine consultant from the UK, although I'm working on the rescue helicopters in Australia at the moment! Certainly from a ER point of view, you are right, it can be stressfull but its also an immensly satisfying and exciting place to work. You never know what might come in through the doors- from major trauma to an ankle injury. Most EDs have good, tight teams so that helps with stress. I can understand that if the specialty is new in Pakistan then it will take time for other specialists to respect/understand your role but that will come with time. Consider this, there have been dozens of TV programs/drama's about ERs, certainly more than any other specialty, that is because its an exciting specialty that makes a difference to the most injured/ill and needy!
Hi, I am a trauma surgeon with over 10yrs experience working in emergency units. Its quite challenging and yes very stressful but I enjoy working in the unit. I guess it depends on ones personality. Doctors that are not cut out for irregular, unpredictable and extensive hours of duty wouldn't want to be there.
Thanks all for valuable comments and suggestions.....
I have submitted my synopsis in this topic for approval and will share my findings soon....
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