Beneficial clinical fellowship in Europe for Japanese Emergency Physician
Introduction: Many Japanese doctors join fellowship in other countries. Practicing in other countries provide us not only clinical skills but also beneficial experiences. European countries provide systematic emergency medical service using helicopters and aircraft as well as high standard ambulances in the emergency medical field. For example, in France, after the Algerian War in the 1950s, a system whose name is SAMU (Service d'Aide Medicale Urgente) and in which a doctor goes to the scene and starts emergency medical care has been developed. In recent years, this system is attracting attention in crisis management measures. On 13th of November 2015, many victims were efficiently transferred to medical institutions, according to the emergency medical plan (plan-blancs) made by AP-HP (Assistance publique- Hôpitaux de Paris). And excellent life-saving effect was demonstrated even in the event of a massive terrorist disaster. Finally, 302 people were injured, but only 4 people died within 24 hours in the terrorist attack. In Japan, pre-hospital emergency medical service has developed with mainly Emergency Medical Technician, but the medical treatments that Emergency Medical Technician can do is limited. For further development of pre-hospital emergency medical service, it needs a system that doctors go to the scene. The author is interested in pre-hospital care in European countries for managing mass-gathering disaster, and stayed Hôpital Universitaire Pitié Salpêtrière, SAMU de Paris and Emergency helicopter base in Tuscany from June in 2016 to August in 2017 for observational fellowship. In addition to reporting the history of development of emergency medical care and the characteristics of pre-hospital emergency medical service in France, we summarized the issues and future prospects of emergency medical service in Japan.
Detail of practice: The author stayed each department for several months, and joined medical treatment with administrator and sometime taught clinical skills and knowledge to medical students. Moreover, the author could join the training for terrorism.
Conclusion: Pre-hospital care system in European countries is advanced. Training for Terrorism is huge scale and extremely real. Many of the systems in European countries do not exist in Japan, and it is necessary to introduced them to Japan in future.
