Dr Colville Laird, Dr James Douglas, Mr Andrew Marsden
Most literature on training practitioners in rural emergency medicine originates in Canada and Australia. However, the geography of Scotland and the structure of its health service are dramatically different and require different solutions. Recruitment of rural health professionals is a major problem. Lack of training and insecurity about emergency medicine are identified as reasons why practitioners do not want to work in rural environments.
In 1993 BASICS Education Scotland started courses in Pre-Hospital Cardiac and Trauma Resuscitation. Demand for these courses, delivered in rural areas, has rapidly increased. The National Health Service now provides funding. A study demonstrated the need for, and what should be included in, an Accident and Emergency Medicine Course covering the accident and emergency work undertaken by rural practitioners. This is being developed.
The Royal College of Surgeons of Edinburgh provides academic leadership. They developed a core curriculum covering the knowledge and skill requirements of all pre-hospital care providers from first -responders to Fellowship level in Immediate Medical Care. They also provide examination at Certificate, Diploma and Fellowship levels. A core curriculum for accident and emergency medicine for rural practitioners, referred to above, is also under development.
Attracting practitioners to rural areas means providing them with appropriate training, which ensures confidence and competence in emergency situations. It is hoped the training described above will be incorporated into a Programme of continuing professional development for rural practitioners.