Dr. James Maskalyk describes emergencies “as a sign of life taking care of itself” in his most recent memoir, Life on the Ground Floor. Throughout his book, the reader is left to wonder what exactly Maskalyk means by this. It is an ominous phrase that, at first glance, reads more like a repackaged “survival of the fittest” for emergency departments. However, through deft and emotional storytelling, Maskalyk urges us to look beyond this stark message of Darwinism and see that emergencies are the purest form of life helping life, or “life taking care of itself”. ...continue reading →
Domhnall MacAuleyis a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK.
A normal day for Dr. Pierre Pili may involve being helicoptered up to a glacier in the Alps, and then lowered by cable 30m down into a crevasse to assess and treat casualties. Few of us see patients in such a difficult and unforgiving environment but this is Pili’s consulting room. A mountain rescue doctor based in Chamonix, he is involved in about 1500 rescues per year, and when not on the mountain, he works as an emergency medicine doctor.
On his first rescue he was called to help two skiers who had fallen deep into an Alpine crevasse. One was dead and one was seriously injured. Pili talks about the mixed fear and excitement of doing this work ...continue reading →
Viktoria Koskenoja is an emergency medicine resident in her fourth year of the Harvard-Affiliated Emergency Medicine Residency
Haley K. Cochrane is an emergency medicine resident in her second year of the Harvard-Affiliated Emergency Medicine Residency
We are Canadian women, born and raised in northern Canadian communities. We are both training to be emergency physicians at the Harvard-Affiliated Emergency Medicine Residency in Boston. While we would like to come home, there are only massive barriers before us.
There is a known scarcity of emergency physicians (EPs) in Canada. The combination of physician shortages, as well as a concentration of specialists in urban centers, has led to regions where up to 70 percent of ED providers have no formal emergency medicine (EM) training. “With a national shortage of trained emergency physicians, most Canadians will continue to have their emergency care delivered by family physicians,” states the Canadian Association of Emergency Physicians, “[with] no guarantee that the family physician staffing a community ED will have adequate training in the management of actual emergencies or in resuscitation.” In recognizing these workforce issues, the CAEP recommended increasing residency spots for CCFP (EM) and FRCP-EM programs as well as increasing the use of mid-level providers. But what about a simpler, more cost-effective option—allow U.S. trained EPs to return to Canada? ...continue reading →