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MCEM and future
How would MCEM exam make a difference to my life? Will it fetch me a good job? Being a degree from UK, and not yet recognised by MCI, what are its implications? Are trainees from India eligible to take FCEM?
Edited by maroju on 10-02-2008 07:56
1) MCEM exam will make a difference in your life.
You'll know how tough it is to get through the exam.
You'll have one of the formal qualifications in emergency medicine in the world which includes FACEP(USA) and FACEM(Australia).

2) It will fetch you a good job. As of today, there are only 3 doctors who have finished MCEM in India and have acquired good positions in various EDs.

3) Medical Council of India has not recognized emergency medicine in the first place. So there are no implications as of now. What happens in the future remains to be seen.

4) Trainees in India are eligible to take FCEM.

Hey, that sounds very exciting!!! But,
1) What is the success rate for this exam?(pass percentage... may again reflect how tough the exam is???)
2) Should things go 'pear shaped' for an ED physician with MCEM, what stance would MCI take (cos' it is not recognised by it?)
3) Is MCEM comparable to FACEP and FACEM or is it FCEM that is on par?
4) What is the eligibility criteria for FCEM for people from our sub-continent?
Edited by maroju on 11-11-2007 19:30
It is heartening that Emergency Medicine has caught up so well. Little surprise then that so many institutes have come up with novel ideas and equally innovative qualifications in Emergency Medicine. As of now, I think there is an MD, Fellowship, PG Certificate course and MCEM. Certainly the DNB board wouldn't want to be left behind and would take every opportunity to start a DNB in EM. I am sure many more institutes are waiting in the wings to join this bandwagon.

On the one hand it is encouraging to see this speciality being embraced and taken forward in a big way. On the other hand, being slightly sinister, I have doubts about the validity of these exams and qualifications.

Who sets the standards? Do these people setting the standards have any formal training in what they are professing and assessing? Have these assessment tools been ratified? Can emergency medicine in the context of our subcontinent be assessed with the same yardstick as used in say the US, UK or Oz?? How credible is the training on offer? Would factors like the type of hospital (Public Sector vs Private sector), patients etc affect the training received by the candidate?

I think these are very pertinent questions that one has to keep in mind before making what could be a very important decision in ones life. Hopefully, that particular institute/course/degree doesn't disappoint the trusted soul halfway through!!!

Certainly there is need for the specialty to be recognised by the MCI first. The specialty still being in its infancy, needs to have a central governing body which oversees research, education, training, accreditation, revalidation and governance etc of its members and trainees and the processes involved. This would help set the benchmarks thus paving the way to a uniform and more reliable system of education and training, thus helping foster the cause of the specialty.
Edited by maroju on 10-02-2008 07:55
At last somebody who is aware of what is going on! Emergency medicine is exploding into India. Pfft

Now there are two types of interests expressed by organizations and people.

1) EM can make a real difference to the hospital, patients, healthcare of a community in general. EM recognition can lead to lives saved. Its a new specialty gives opportunity for EM physicians, EM nursing, Emergency medical technicians (paramedics), etc to work and contribute in hospitals and society. As well as earn a good deal of money.

2) EM / EMS is also a huge opportunity for organizatons and people with vested interests to make a great deal money and fame.
But this doesn't mean every organization starting a new EM course has decided to ruin people's career. It upto the person joining any program to do a through check on the course details and teaching faculty.

At this time the society of emergency medicine, India (SEMI) is the central body governing a small aspect of the growth of emergency medicine in our country. Now SEMI is important because it the body which has been recognized by other countries.


Emergency physicians in India are divided into the following groups:

a) Persons who have a US/UK/Australian EM qualification like FACEP, FCEM/FACEM

2) Persons who have 3 year MCEM (Member of college of emergency medicine, United Kingdom)

c) Persons who have 3 year MD (Emergency Medicine) from Indian institutes

d) Persons who have a 1 year Fellowship in Emergency medicine

e) Persons who have a 1 or 2 year Diploma in Emergency medicine

(Note that neither MD in EM, or any other course has been recognized by the medical council of india as of today)

f) Persons who have gained experience in the field of emergency medicine by working in EDs, ERs, EMS for many years but have no official degree but have done some EM related courses.

g) Persons who have degrees in anesthesia, respiratory medicine, general medicine or critical care who call themselves emergency physicians

h) Persons who have just done their Basic Life Support and Advanced Cardiac Life Support courses and call themselves emergency physicians.Angry

i) Persons who think they are emergency physicians because they control some aspect of a hospital's 'casualty'.Angry

j) Persons who are full fledged qualified emergency physicians in their home countries but visit Indian institutes frequently to contribute to EM's growth.Pfft

k) Persons who have done a 6 month correspondence course in EM!

l) Persons who are Indians and are a part of some EM related organization in another country who believe they are contributing to Indian EM by just visiting an Indian institute or EM conference. Grin

m) Persons who are not qualified doctors but think they are EM physicians because they were working with some emminent EM physician or organization

Every person has made some contribution or the other for EM's growth. Some very critical and significant, some which are damaging to EM's growth.

These contributions are necessary for EM's growth now. A point will come when this disorganized growth will become detrimental to the specialty of Emergency medicine.

The main point for any person who wants to get into an EM course in India today, is to first make sure whether he/she wants to take up EM as a career. If yes then he/she must verify the credentials of the program. The teaching faculty MUST be from qualified emergency medicine background and must have pure EM experience.
This is not entirely possible because this is the beginning. Most programs are self sustaining, (creating students who will be the future faculty). This also means that if the course is not organized well, incompetent persons will start teaching EM.

Today there are informal indicators for the performance of a particular EM course, or to assess the competence / skills of the person who has qualified from a particular course, which helps in ranking an EM physician.
This is used by certain hospitals for recruitment as well as to fix their pay. The general student/resident population will come to know this once the first group of EM physicians pass out of their respective courses and start working/teaching.

Regulation of all Emergency medicine related courses and activites will happen in the near future. There is no doubt about it. Probably by SEMI. This also means the people who are governing SEMI must also be qualified and experienced EM physicians. I dont want to imagine an institute or organization or people who have no understanding of EM to govern the specialty. (This is highly possible in a country like ours where politics rule)

I dread the day when MD and DNB recognizes EM and opens the program in all colleges. Who are the people who will teach the PG students. There aren't sufficient EM trained physicians today. I hate the situation when an anesthetist or cardiologist or orthopedician starts teaching students about EM and trauma management.

Edited by imron on 17-02-2008 12:44
Thank you Imron for that well rounded response. Your classification of the various 'EM Doctors" is interesting.
I think we are kind of expressing similar sentiments regarding the governance issues. Hope good and common sense will prevail and the reins are not handed over to a bunch of amateurs or people with vested interests (like politicians, businessmen etc).
There is also the unavoidable threat of using the specialty as a money spinner by some hospitals. Wonder if this is already the case??
Edited by maroju on 26-02-2008 09:38
Yes. It has happened already at a certain location leading to its collapse. Such an agenda is usually not sustainable for more than a year or two.
Sadly it has resulted in loss of significant amount of career time and money to a small number of aspiring EM residents. Frown
Edited by imron on 03-02-2008 14:23
[quote]maroju wrote:
Hey, that sounds very exciting!!! But,
1) What is the success rate for this exam?(pass percentage... may again reflect how tough the exam is???)
2) Should things go 'pear shaped' for an ED physician with MCEM, what stance would MCI take (cos' it is not recognised by it?)
3) Is MCEM comparable to FACEP and FACEM or is it FCEM that is on par?
4) What is the eligibility criteria for FCEM for people from our sub-continent?[/quote]

1) Pass rate for Part A (Basic Sciences) is about 18-23% (Both in UK as well as Hyderabad). This sure is a very tough exam. Believe me!
Pass rate for Part B and Part C is 50-60% (Both UK and Hyderabad)

2) I have no idea what MCI will do.

3) MCEM is a step towards FCEM. All though MCEM at Hyderabad is following the UK curriculum, it is providing broad, unrestricted EM experience to its residents. The equivalent of any 3 year EM residency as in USA. How MCEM is interpreted in India remains to be seen.
FACEP is a 3 year or a 4 year residency in USA
FACEM is a 5 year residency in Australia (If i'm not wrong)

MCEM is a 2 year residency in UK
MCEM is a 3 year residency at Apollo Hyderabad, India
FCEM is a 4 year program in UK after completion of MCEM

4) Eligibility criteria for FCEM from our subcontinent is to have finished
MCEM part A, B and C sucessfully, either in UK or at Hyderabad. Right now there is nobody who has gone to UK to do an FCEM from here.
Looks like the forum is gearing up to some gr8 discussions and it fantastic to see people who are in the relevant field talk about the experiences and vision.
My sincere appreciation all the people who are trying to bring EM onto the main stage of medical practice in India.The efforts of the website and the webmanster are very much laudable.I don't think there is anything left for me to say about this issue, but its going to be a longterm effort from all the people involved in the field to make things happen.
Few things about EM training

1) As EM training is very new in country it needs major commitment not only from the EM trainers but also from all the other Specialties to provide a quality training.

2)A regulatory body.....who??????????? MCI/SEMI/A institute which is the harbinger.I think its time to set some standards for POST GRADUATE medical training in India and they can be very much started from EM.

3)Courses: Who will teach and what will they teach? and is it upto the standards!!!!!!!!!! I think there should be away to churn out the future faculty from the courses so that they can spread the knowledge and skills.

4)Practice:It is very difficult to untie money from any practice in India as most of the health care is consumer driven and the implications on EM as a main frontline dept of any hospital is more.

5)EM nursing training:This is as much important as EM docs training and this can be slowly addressed by developing some sound nursing leaders by the EM physicians.


Come on Guyz u can rock.
There are three types of EM personnel who need to be qualified...

1) Emergency Medicine Residents, Registrars & Consultants
2) Emergency Nurses & Nurse Supervisors
3) Emergency Medical Technicians (Commonly known as paramedics)
and EMT supervisors

Like STEMLYNS says, the EM future in India is great! It will evolve itself in a country as unique as ours and its path cannot be predicted.
Edited by imron on 03-02-2008 15:34
With the latest changes in regulations to employment of overseas doctors into training programs in the UK, it appears that pursuing MCEM or FCEM (or for that matter any other specialty) there is difficult.

Regarding the three types of EM personnel, I think there is one more type that could be added to the list. They are doctors who are trained in pre-hospital care. These doctors have specialist skills in retrieving and transferring patients who are acutely unwell in the pre-hospital setting to a point of definitive care. It is not just a supervisory/advisory role.

I think a system of good pre-hospital network is already evolving in many states/cities.
Edited by maroju on 05-02-2008 20:55
With the recent decision by MCI to recognise EM as a specialty in its own right, several institutes which have already been running their own EM training programs have really got a shot in their arm. They probably are already ahead of what I can see to be a 'rat race' to set up EM programmes over the coming months/years.
This also would really stir up a few things.
1. Initiatives need to be set up to train the trainers
2. Create a core curriculum
3. Have a system of evaluation of the services and also the training program.
4. Change in the mindset and perception of other specialties to EM
5. How much funding would the specialty attract from the respective governments or educational boards?
6. What would be the future of MCEM in India? Would people be willing to spend that much money on the course and exams? Would the College of EM/Appollo come up with a better 'deal'?
What is good about this decision is that the common man is the clear winner, assuming the quality of care in 'casualty wards' would improve...
Edited by maroju on 18-08-2009 17:26
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