Thanks to the Spirit of 2010 award, I was able to spend my elective in Ireland, getting to know the healthcare system as well as the ins and outs of emergency care. I spent my time with Dr. Andy Neill, an avid proponent of #FOAMed (Free open access medical education) and emergency physician at the Mater Misericordiae University Hospital in Dublin.
During my clinical time there, I realized that there are as many similarities as there are differences in the way we practice. Many of the similarities lie in the shared frustrations of EP's everywhere, though we have much more litigation concerns here in the US than they do in Ireland. The differences are many. One of the most striking differences is the structure of staff there. Very few doctors seek out EM as their specialty. Their equivalents of attendings play a much more administrative, hands-off role and do few clinical shifts, if any. Most of the resident staff in the ED at a given time are rotating residents from other specialties who spend as much as six months at a time there.
Another observation was that of the lack of a regulated trauma system (though it is something they are working towards). Right now traumas can go to any ED and most rely on a general surgeon taking home call overnight to respond to emergencies. Luckily traffic is tight in Dublin, so they don't see a lot of high speed MVCs.
Lastly, I was able to learn a lot from Andy about the FOAMed movement. Andy's blog "Emergency Medicine Ireland" contains tips, tricks and pearls for EM physicians everywhere. We reviewed podcasts and spoke a lot about emergency medicine education and where it is headed. Exciting things are in store and I was glad to be a part of it. Thank you, 2010!