Emergency Medicine is a primary specialty established using the knowledge and skills required for the prevention1 , diagnosis and management2 of urgent and emergency aspects of illness and injury, affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioral disorders.
This includes organizing the proper medical response for patients looking for urgent medical care.
Time and timing in this setting may be critical either from a medical or from the patient’s point of view.
The practice of Emergency Medicine3 encompasses the in-hospital as well as out-of-hospital4 triage, resuscitation, initial assessment, telemedicine and the management of undifferentiated urgent and emergency patients until discharge or transfer to the care of another health care professional.
1 Prevention: also includes injury prevention, preparedness for disaster, as well as public health education.
2 Management encompasses the local service organization as well as the development of systems to provide EM care.
3 Primarily hospital-based
4 This applies to out-of-hospital emergency care, disasters and includes other urgent medical care systems outside hospitals.
Status of EM
Europe encompasses not only fifty or more different languages and cultures, but also a similar number of different systems of health care and medical practice. Each country has different medical traditions, different systems of professional registration and differing lists of medical specialties. This latter problem has been addressed in part by the European Union and, in particular, by the Department or Directorate-General which deals with the Internal Market and which includes the mutual recognition of diplomas and other free movement issues. The relevant EU Directive for medical qualifications is known as the ‘Doctors’ Directive’ and was first issued as 1993/16/EC, but most recently updated as 2005/36/EC (January 2019).
The Directive requires that the period of training for Emergency Medicine should be a minimum of five years and many EU countries have now recognized Emergency Medicine as a primary specialty with these training requirements. Emergency Medicine also exists in several countries as a supra-specialty.
Annex V to Directive 2005/36/EC included 16 countries with the specially of emergency medicine, with a minimum of 5 years program. Not included in the list Belgium, Germany, Greece, Spain, France, Cyprus, Latvia, Lithuania, Luxembourg, Holland, Austria, Portugal.
See complete list of EM as primary specialty and number of training years per country here.
Several of the remaining EU countries are making significant progress towards recognition of the specialty, but it can be a slow and arduous journey! Nonetheless, there has been a very significant increase in the recognition of Emergency Medicine as a primary specialty in Europe during the last decade and this is in line with the rest of the world where there is similar growth in recognition of the specialty.