By Ira Nemeth, MD
Vol. 13, Issue 3, July 2004
I started researching fellowship opportunities while attending the American College of Emergency Physicians’ meeting in Boston. During my research of this topic, I found three truths: disaster fellowship programs are hard to find, the disaster fellowship knowledge base varies, and there are programs that cover a wide range of topics.
Finding disaster medicine programs was not simple. The Society for Academic Emergency Medicine’s (SAEM) Web site only lists programs at George Washington University and Brown University. Through other means, such as word of mouth, I learned about programs at the University of Massachusetts, the University of Alabama, Wayne State University, the University of Texas Southwestern, Johns Hopkins University, the University of California - Los Angeles, as well as something new in Boston. I searched the Internet and e-mailed all emergency medical services (EMS) fellowship directors listed by SAEM, with limited success.
Curriculums at the programs I contacted varied considerably. Defining your own goals as a fellow when there is no clear agreement on the knowledge base of a disaster fellow is a difficult task. When someone hires a toxicology fellow, EMS fellow, or ultrasound fellow, there is an understanding of the knowledge and experience that this person brings to your emergency department. Hiring a disaster fellow is currently a much more ambiguous proposition. What benefit does a disaster fellowship-trained physician add to an emergency practice? What knowledge base and skill set do I add by training as a disaster fellow?
There is a wide variety in the programs out there. Programs vary in length from one to two years and may include a masters of public education (MPH) or other graduate-level degree. Some of the EMS fellowship directors felt that the EMS curriculum covered the topic of disaster medicine. The programs at George Washington University (operational medicine fellowship) and the University of Massachusetts combine elements of disaster and EMS fellowships. The Fire Department of New York (FDNY) EMS fellowship also spends some dedicated time learning disaster medicine. International fellowships at Johns Hopkins, New York University (NYU), and Harvard cover disaster medicine issues. The University of California at Los Angeles and the University of Alabama’s programs are listed as disaster research fellowships. The program at Wayne State University gets the fellow actively involved in disaster planning in a large city. The Government Emergency Medical Security Services fellowship (GEMSS) is a unique program at the University of Texas Southwestern Medical Center. The program is designed to create a physician who can interface with all areas of government agencies from VIP protective services to tactical medicine to weapons of mass effect.