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Emergency medicine has been used in Iran for more than 43 years. Establishment of this field was due to responding to increased expectations of the public for having 24-hour access to professional medical care in the first moments of referring to a healthcare center. Several attempts have been made since the 20th century to organize the emergency departments and train skilled workforce for working in the emergency room. However, the first course of training resident of emergency medicine goes back to August 1968 in University of Cincinnati, Ohio, Unites States of America with the help of a young specialist called ”Dr. Herbert Flsa”. In addition, Dr. Buice Janiak was appointed as the first resident of emergency medicine in 1970. However, the first round of residency of this field was significantly different than what is common today. Assistants of a two-year course only worked in emergency department for two months. This was mainly due to the fact that first, medical emergencies are better taught by specialists of each field and second, there was almost no emergency expert to teach the residents. In addition, specialists of other fields never have to go to the emergency department since this was the place to train interns and residents of a specific field.
In a short duration after University of Cincinnati, Dr. Wagner established the independent course of emergency medicine residency in school of medicine of Pennsylvania and his first resident in 1971 was Dr. Palma Bensen, who greatly endeavored for establishment of this field despite her pregnancy.
The first emergency medicine residents learn a lot during these courses by just visiting a numerous number of critically ill patients without an official curriculum and educational plan and with never-ending interest and quest. They were all regarded as strange individuals who have chosen a field of study with unclear future. It was not even regarded as a field yet. Nevertheless, endless efforts of these residents, who proved their competence, yielded positive results and American association of specialized boards endorsed the fact that emergency medicine is an independent specialized field and is necessary for patients. Therefore, the American society of emergency medicine specialists was officially established and the field of emergency medicine was regarded as the third specialized field.
Necessity of establishment of this field in Iran was first introduced in 1996 by Dr. Abdollah Bahrami, president of Mashhad University of Medical Sciences at that time and the current manager of emergency medicine department of this university. Despite the preparation of the infrastructures in Mashhad University of Medical Sciences, implementation of this project was delayed. In 2000, establishment of this field as a strategic plan was expressed by the ministry of health and medical reform once again, and Iran University of Medical Sciences prepared a department under the supervision of Dr. Ali Bidari. The mission of this department was training the first round of emergency medicine assistants of Iran. Moreover, the emergency medicine association of Iran was established in October 2005 (website: www.isem.ir).
Today and after 15 years, Shahid Beheshit, Tehran, Tabriz, Mashhad, Isfahan, Ahvaz, Military and Baghiatollah universities have courses for training assistants in this field. Given the ability of emergency medicine for promoting the level of care and increasing patient satisfaction and its clinical attractiveness due to diverse symptoms and diseases, this field has been turned into one of the most popular specialized fields in America and many countries of the world.
Objective and Perspective
Emergency specialists have the required knowledge and skill for managing emergencies of various medical fields. For example, an emergency expert (e.g., anesthesiologist) is able to manage the airway of patient and ventilator settings, diagnose and treat myocardial infarction and arrhythmias similar to a cardiologist, insert chest tube, shaldon and central venous catheter similar to a surgeon, treat dislocations and fractures without surgery similar to an orthopedist, manage nose bleeding and perform cricothyroidotomy similar to an ENT expert, perform ultrasounds in trauma and emergency procedures with the help of ultrasound similar to a radiologist and manage the emergencies of this field such as an internist.
Other skills emergency experts learn during their training, which are specific to this area, include management of patients with repeated traumas, shocks, respiratory impairments, environmental diseases (drowning, electric shock, heat exhaustion and frostbite), patients in need of CPR and management of crises and natural disasters and chemical and nuclear victims. Furthermore, these experts have special skills in emergency management fields, including management of emergency department, physical design of emergency department, crisis management in society and prehospital emergency management.
Today, fellowship courses of this field are provided for more than 15 subgroups, such as pediatric emergency, poisoning, crises and natural disasters management, emergency ultrasound, intensive care and trauma. For more information, please visit the following website address: