Spotlighting our Local Heroes with a Global Impact

James Stempien

Provincial Head of EM for the CoM and SHA 

Saskatoon, SK 

Journey to EM:

Dr. James Stempien graduated medical school from the University of Toronto in 1984 followed by a rotating internship and a year of anesthesia in Newfoundland. His journey then took him to various locations, including Northern Canada and overseas before he eventually wrote his CCFP EM exam. 

Why is Global EM important to you?

Global EM holds significant interest to Dr. Stempien due to his 2 month experience as a medical student in Papua, New Guinea. During this experience, he found it captivating to be able to learn from the nurses and physicians there. He saw the difference in availability of facilities as an opportunity to make a meaningful contribution and help out. 

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

While the majority of his EM experiences have been in Saskatoon over the past decade, he had previously worked in Papua, New Guinea. Additionally, he has worked for the International Committee of Red Cross in Sudan, providing support to victims of the Sudanese Civil War. 

Since he has been in Saskatoon, he has gone to Nepal twice to hold the position of an “external examiner” at the Tribhuvan University, supporting Emergency residents during their first exams. 

After his first visit, he was quite enthusiastic about going back to Nepal to continue to provide assistance. 

These diverse experiences have exposed him to different healthcare systems and have allowed him to meet some great people. These experiences provide him with broader perspectives, diversify his skills, and contribute to the development of Global EM. 

Have you done any focused training related to Global EM?

Dr. Stempien received some training ahead of time when he worked for the International Committee for the Red Cross. Additionally, he underwent training to teach a trauma course in Uzbekistan. 

What current projects are you involved in or past projects that you would like to share?

Dr. Stempien has a growing relationship with Juba, South Sudan and its teaching hospital, collaborating closely with another EM physician from Saskatoon who is originally from South Sudan. Moreover, he and another physician from NIgeria have been interacting with the Dean of Juba Medical School, who is aware of the emergency medicine program that exists in Addis Ababa, Ethiopia, and was hoping to create something similar in Juba. The University of Saskatchewan has shown support for this initiative and efforts are underway to develop a memorandum of understanding with Juba University to ensure it receives benefits with this partnership. 

Tell us about one memorable experience in a city or country where you’ve worked/visited?

Dr. Stempien’s first child was born in Papau, New Guinea. He was the main physician in the town of Yallabu, located in the southern Highlands province. He was faced with the dilemma of being the only physician there to deliver his wife’s baby. To ensure a safe delivery, they traveled to a neighboring town and delivery went smoothly. However, the post delivery process was different from that of North America. Rather than staying in the hospital for a day or so, they were promptly discharged. Him and his family celebrated this moment by enjoying a well-deserved drink at a hotel. 

What are some unique challenges that you have faced while providing emergency medical care in different countries or regions? 

Providing medical care in different countries has exposed Dr. Stempien to unique challenges, often stemming from limited resources. For instance, in Papua, New Guinea, he encountered a lack of a generator at a hospital resulting in intermittent power at night. Consequently, surgeries and medical care in the evening was heavily disrupted during power outages which would sometimes last days. Resource scarcity included limited supply of sterile gloves, resulting in reusing gloves and using outdated antibiotics. 

In Sudan, Dr. Stempien was sometimes operating out of tents and occasionally operating rooms had 3 different tables in the same room. This consisted of emotionally challenging scenarios in which people were getting leg amputations due to stepping on landmines, and other physicians would come in for their operation witnessing these procedures. 

Overcoming the initial learning curve of the new system and the limited resources presents many challenges, but once familiarized, these tools can be used effectively. 

Twitter handle: @docstemp

Segun Oyedokun

Clinical Associate Professor, Department of EM 

University of Saskatchewan 

Journey to EM:

Dr. Oyedokun obtained his medical degree in Nigeria and initially pursued training to become a gynecologist. However he relocated to South Africa and switched to Family Medicine at University of Pretoria. At the same time, he enrolled for a diploma in tropical health to further enhance his expertise. In 2003, he relocated once again to Saskatchewan and worked rural for a few years before he eventually got accepted into the CCFP EM residency training program in Saskatoon. In 2017, he enrolled in a post graduate online course in aeromedical retrieval and transport at University of Otago, New Zealand as this has always been an interest of his.

Why is Global EM important to you?

Dr. Oyedokun is an international physician who comes from a resource-limited third world country. His works in different countries have served as eye-opening experiences, revealing the pressing need for improved health care services worldwide. He considers himself blessed to be living in Canada and now aspires to extend his support to less fortunate countries. The combination of his close family friend working in the WHO office in Nigeria, and his tropical health course, made him interested in Global Health from the start. As time progressed, his interest evolved into a commitment driven by a sense of duty. 

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

On one hand, engaging in Global EM has allowed him to explore and satisfy his interest and on the other, it has helped him in addressing healthcare needs. In 2014, he went back to the medical school he graduated from to run workshops on topics such as sepsis, trauma resuscitation and basic life support. This experience not only provided him with a sense of fulfillment but also highlighted the importance of further similar endeavors. Thus, he has been helping them since. 

Moreover, his involvement with the CAEP Global EM committee which began in 2021, has allowed him to contribute to the Global EM series, a paper that is in its finalizing process. CAEP has allowed him to meet like-minded individuals and gain valuable insight into the potential impact of health care initiatives on global scales. 

What current projects are you involved in or past projects that you would like to share?

Dr. Oyedokun’s projects collectively reflect his commitment to advancing EM through training, policy development, and international collaboration, as well as his dedication to making a positive impact in the field. 

One notable accomplishment is the publication of a review on out-of-hospital EM care in Nigeria, which was featured in an African journal of Emergency Medicine. This review aimed to shed light on the current state of prehospital care, highlighting barriers, needs, and gaps in the system. If interested in learning more, access the full article at https://authors.elsevier.com/sd/article/S2211419X23000290. 

In addition, he is also actively collaborating with a colleague from Saskatoon and another from South Sudan on an ongoing project to develop an EM program. There are current discussions with the University of Saskatchewan to establish a memorandum of understanding that will foster a collaborative relationship and help in the development of the program. 

Moreover, Dr. Oyedokun is privileged to serve as a coach for a pre-hospital working group in Nigeria, a branch of the Emergency Medicine Interest Group. This group plays a role in supporting and promoting the development of EM in Nigeria. 

He is also proud to be a part of the Canadian Association of Nigerian Physicians and Dentists who have recently partnered with the Family Medicine Residency Program in the central part of Nigeria. As a part of this collaboration, Dr. Oyedokun and his team provide monthly lectures to the training program, and has delivered 3 lectures in the past year. 

Tell us about one memorable city or country where you’ve worked?

His favorite place to work was at a large regional hospital in a very rural area in South Africa for 5 years. It was amazing to see how much work he can do as a family physician with little specialized support and incredibly rewarding to support the healthcare needs of the rural population.  The experience provided valuable insights into healthcare delivery resource-limited settings and strengthened his commitment to making a difference in underserved areas. 

What are some unique challenges that you have faced while providing emergency medical care in different countries or regions?

While he has not personally practiced EM outside of Canada, he has encountered unique challenges in delivering medical care in various areas. The biggest challenge has always been limited resources. However, he likes to focus on the rewarding aspects of being able to make a difference despite these limitations. By utilizing what he has, he is able to provide care for local populations without the need to send them 100 km away. 

Twitter: @Segun_Taofiq 

Emergency Medicine Residency Program CFPC-EM 

Program Director 

University of Manitoba

Dr. Kowal volunteered with MSF in 2007 and 2010. After returning from her MSF missions, she worked part time as an EM physician and part time at an HIV clinic. Once her kids are older, she hopes to get involved with Global EM and plans on traveling to teach POCUS in the near future.

Alicia Ruhi Cundall

Dr. Cundall did her Family Medicine residency and EM training at Western, followed by Ped EM fellowship at U of T. She is currently a professor at University Health Network (UHN), Toronto and is currently working as a family practitioner. 

Why is Global EM important to you?

Global health has been the driving force behind Dr. Cundall’s journey to medicine. Having been born in Papua New Guinea and spent her early years in Tanzania, she witnessed first hand the challenges faced by underserved communities. She always wished to acquire practical skills that could be of service to humanity–medicine, especially EM was a perfect example of this. 

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

Dr. Cundall believes that global health attracts like-minded individuals, which has positively influenced her relationship with colleagues and mentors. Global health serves as a source of inspiration and motivation beyond her clinical work. Global health goes beyond her day-to-day clinical work, it drives her to pursue her dreams and goals, which are much bigger than what is necessarily done in the ER. The knowledge and experience gained through her work with third-world countries has been valuable, not only in those contacts but in rural Canadian settings as well. Thus, her work has also informed how she practices academic and clinical medicine in Canada. 

Have you done any focused training related to Global EM?

Prior to medicine, Dr. Cundall did a five year bachelors honors degree in international development and global health. This involved an internship with the Zambian Ministry of Health for a year and doing ground research in Zambia. She also did some work with the United Nations before medical school and during as well. 

What current projects are you involved in or past projects that you would like to share?

She currently directs a Canadian not-for-profit called EM Global, which was founded in 2018. The organization seeks to build capacity in EM in low resources contexts. They started with portable ultrasound and expanded their efforts into simulation and other areas. A significant aspect of their work includes sponsoring local Tanzanian doctors or medical students to pursue EM training. Due to multiple barriers, there are currently under 100 trained EM physicians in a country of 59 million. However, steps are being taken to improve access to training, for example, a second EM training site has just been launched at EM Global’s partner hospital, KCMC, in Kilimanjaro region, Tanzania. 

Dr. Cundall is also involved in a research project through UHN, that focuses on different simulation models. They have coined a model called “low resource high capacity” (LRHC) and are developing simulation cases that are applicable in an Ethiopian context. Instead of simulation cases that assume certain resources, they are collaborating with colleagues in Ethiopia to understand the resources available, such as antibiotics, IO gun, and respiratory therapy, and how to manage cases accordingly in that context. This information is used as part of pre-departure orientation for residents and staff going to Ethiopia or other low resource settings, enhancing their preparedness and training for the specific challenges they may encounter. 

Tell us about one memorable city or country where you’ve worked?

During her time in medical school, she had the chance to do an elective in Amman, Jordan with the Center for Victims of Torture. They were at the border of Syria and worked closely with many Syrian refugees. The focus of the work was to train local providers in emergency mental health, which was a new concept for her. The organization trained Arabic-speaking psychotherapists to offer programming that helps individuals rehabilitate after traumatic experiences. This experience left a lasting impression on her throughout her medical training.

What are some unique challenges that you have faced while providing emergency medical care in different countries or regions?

Dr. Cundall reflects on her experiences working in remote parts of Ontario, specifically Terrace Bay and Sioux Lookout. In these rural areas, she faced challenges of limited access to specialists and resources, unlike urban centers like SickKids, where anything is readily available. In rural settings, emergency doctors must be particularly dynamic and capable due to having to manage the same sort of presentation with significantly fewer medical resources, whether that be in Canada or Tanzania. For instance, in remote settings, they may have to call lab or xray techs to come in hours away, leading to delays in essential tests. When delays exist, they must make decisions more quickly and initiate treatment to save the life of the patient even without all of the information. With a strength-based lens, one can see the incredible capacities of physicians who practice in such settings.

Twitter: @Global_MindedMD

Current Position: Consultant for Alberta Health Services, Calgary AB

Background: 

Dr. Cheri Nijssen-Jordan is a highly accomplished medical professional with a career spanning over 40 years. She began her medical journey in Saskatchewan, where she completed her medical school education. From there, she migrated to different locations, including Halifax, Ottawa, and Calgary, where she established a strong base due to the city’s convenient international airport and proximity to the mountains.

Dr. Nijssen-Jordan’s expertise lies in pediatrics, specifically pediatric emergency medicine. She started her career as a staff member in pediatric emergency in Halifax, where she played an active role in various medical associations and committees, such as the Canadian Association of Emergency Physicians (CAEP) and the Royal College emergency medicine specialty committee. She even contributed to defining the pediatric emergency sub-specialty and the pediatric component of the emergency medicine sub-specialty.

In addition to her pediatric specialization, Dr. Nijssen-Jordan’s first exposure to international work involved her time as one of the only doctors in a hospital in Lesotho, Southern Africa. This early exposure to global health motivated her to pursue international work and volunteer with organizations like Doctors Without Borders.

Throughout her career, Dr. Nijssen-Jordan has held several leadership positions within Alberta’s medical system. She served as the Director and Division Head of Pediatric Emergency Medicine at the Alberta Children’s Hospital and later became the Facility Medical Director of the South Health Campus hospital. She has also been involved in teaching pediatrics at the University of Calgary’s Faculty of Medicine.

Dr. Nijssen-Jordan’s dedication to public health was evident during the COVID-19 pandemic when she co-led the COVID Vaccine Task Force at Alberta Health Services, overseeing the distribution of COVID-19 vaccines throughout the province.

Outside of her clinical and administrative work, Dr. Nijssen-Jordan has actively contributed to various medical boards and organizations, including the College of Physicians and Surgeons of Alberta, the Canadian Medical Alert Foundation, and the City of Calgary Medical Control Board for Emergency Medical Services.

She holds a Doctor of Medicine degree from the University of Saskatchewan and a Master of Business Administration from the University of Calgary, highlighting her commitment to both medical expertise and healthcare management.

Why is Global EM important to you?

“I would have to say that the key thing for me is that universal healthcare and emergency care has always been something that I consider a right of every person and it doesn’t matter where you’re from or who you are […] a human is a human”. 

Dr. Cheri Nijssen-Jordan’s commitment to universal healthcare and emergency care is a central aspect of her career. She strongly believes that everyone, regardless of their background, deserves access to healthcare. For her, being human is the only affiliation that matters, transcending differences in color or origin.

Early on in her career, Dr. Nijssen-Jordan recognized the privilege of living in Canada and North America with abundant healthcare resources. However, she felt the need to venture somewhere that lacked the same level of medical infrastructure. Her goal was to develop robust clinical skills and provide essential care to underserved populations. This desire led her to pursue medicine, driven by the genuine intention to help others.

Dr. Nijssen-Jordan embraced the opportunity to enhance her clinical expertise, serve communities in need, explore different cultures, and foster connections with people worldwide. With the support of her husband, who possessed engineering skills in rural development and water sanitation, they formed a formidable partnership.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

 “If you have a mom that’s concerned about a fever in her kid in Canada, that’s no less concerning to her than a fever of a kid to a mom in South Africa”

Dr. Cheri Nijssen-Jordan believes that her experience working in areas with limited medical resources has significantly enhanced her clinical skills and resource utilization. She emphasizes that her history taking, physical examination, and overall clinical abilities have greatly benefited from her international work. This exposure has made her appreciate the excellent healthcare opportunities available in Canada. 

Dr. Nijssen-Jordan’s international experience has made her a more patient consumer, as she understands the challenges faced by underserved populations who may have to travel long distances or endure extended wait times for care. She urges her colleagues and the public to recognize the privileges they enjoy and the high quality of care available in Canada.

Balancing between different types of clinical practice has been a challenge, but Dr. Nijssen-Jordan has developed the ability to compartmentalize and adapt to different protocols and resource availability. She has learned that regardless of location, the concerns and needs of patients and their families remain the same. This understanding keeps her grounded and focused on providing the best care possible, regardless of the circumstances.

Have you done any focused training related to Global EM?

Dr. Cheri Nijssen-Jordan’s commitment to global health and her desire to enhance her clinical skills led her to pursue additional training in Tropical Medicine and hygiene. Recognizing the importance of understanding diseases rarely seen in Canada, she obtained a diploma in Tropical Medicine in Lima, Peru. Additionally, she recognized the value of ultrasound as a versatile tool, particularly in remote areas with limited resources. To better utilize this technology, she underwent extra training in bedside ultrasound, which proved invaluable in her practice, especially in rural and underserved regions.

She pursued a Master of Business Administration (MBA) degree. This decision proved instrumental in developing her operational management skills, enabling her to effectively manage departments, negotiate, handle HR issues, and approach conflicts with patients. She advocates for including similar courses in emergency medicine training, as they provide fresh perspectives and valuable insights, especially for those involved in global health initiatives where intergovernmental relations and negotiations with diverse entities are critical.

What current projects are you involved in or past projects that you would like to share?

Dr. Cheri Nijssen-Jordan has been involved in various noteworthy projects throughout her career. In North America, she played a pivotal role in designing Calgary’s new Children’s Hospital and the South Health Campus. Additionally, she served as an administrator in Fort McMurray, gaining valuable experience in running a portion of the healthcare system.

However, one of her most fulfilling projects took place in Laos, Southeast Asia, where she had the opportunity to open and run a new Children’s Hospital. Dr. Nijssen-Jordan organized a team of over 126 volunteers, including physicians specializing in emergency medicine, pediatrics, and residents from both disciplines. The project focused on improving emergency care, and the hospital’s emergency department became a training ground for resuscitation skills and critical care.

In Laos, there was a significant number of small infants with population-specific vitamin deficiencies, leading to cardiac arrest and failure. The team implemented a protocol involving resuscitation, intubation, and administering thiamine. After approximately two hours of treatment, these infants would regain consciousness, breastfeed, and be discharged the following day with appropriate ongoing management. The experience provided ample opportunities for practicing intubation and teaching critical skills to residents and staff. The knowledge exchange and teaching opportunities left a positive impact on all involved, fostering ongoing support for the hospital in Laos.

Tell us about one memorable city or country where you’ve worked?

When asked about her most memorable city or country where she has worked, Dr. Cheri Nijssen-Jordan acknowledges the difficulty in choosing just one. However, her mission in northern Syria with Doctors Without Borders stands out as the most impactful experience for her.

As a flying pediatrician, Dr. Nijssen-Jordan was responsible for various projects, including pediatric care and covering adult emergency medicine. Working in a war zone provided a unique perspective, where she realized that regardless of which side a person was on, once injured, they became a casualty deserving of medical attention. Doctors Without Borders operates under the principle of treating anyone in need, irrespective of their affiliation.

The situation in Syria deeply saddened Dr. Nijssen-Jordan. The country had a strong healthcare system with renowned research and highly skilled medical professionals. However, the conflict in 2011 devastated the system, leaving a profound impact. She reflects on the challenge of rebuilding the healthcare infrastructure and providing care to combatants and civilians alike.

While each project has had its memorable moments, such as teaching emergency medicine courses in Kuwait and Taiwan or conducting a bedside ultrasound course in the Central African Republic, the experience in Syria had a profound impact on Dr. Nijssen-Jordan. Treating patients, regardless of their background, remains a core principle in her humanitarian work.

What are some unique challenges that you have faced while providing emergency medical care in different countries or regions? 

“It’s trying to use the resources that you have in the best possible way to give the best outcome for the patient. For me that’s one of the the most unique things about every single place because they’re all different”

In North America, access to various specialty consultations is readily available, ensuring optimal patient care. However, this is not the case in many global health settings. Physicians must rely on critical thinking to diagnose and treat patients with limited resources. Dr. Nijssen-Jordan shares an example from Pakistan where resuscitation efforts for babies born at home were challenging due to delayed arrival, resulting in long periods of hypoxia and subsequent complications.

She emphasizes the importance of using available resources effectively to achieve the best patient outcomes. Dr. Nijssen-Jordan highlights the varying healthcare landscapes in different regions. For instance, she mentions the impact of war in Syria, where a well-established system for treating thalassemia collapsed, leading to unsafe practices. Efforts were made to reinstate safe transfusions and secure affordable medications.

Dr. Nijssen-Jordan also stresses the need for adaptability and critical thinking in global health emergencies. She shares her experience in the Central African Republic, managing a measles epidemic alongside the ongoing COVID-19 outbreak. She encourages healthcare professionals to explore different avenues to contribute to global health, such as fellowships, partnerships with organizations like Doctors Without Borders and the Red Cross, and providing immediate assistance during crises. She advises against engaging in medical tourism and emphasizes the importance of sustainable contributions that have a lasting impact on healthcare outcomes worldwide.

Current faculty/position?: Staff physician at BC Children’s Hospital and Vancouver General Hospital 

Where are you currently located?: Currently based in Vancouver, BC

Where did you do your residency?: UBC (Vancouver) 

Why is Global EM important to you?:  

Dr. Douglas-Vail believes that global health represents health equity taken to its logical conclusion – the pursuit of the best care for every patient everywhere, advocating for vulnerable patients and striving to enhance emergency care worldwide. Emergency medicine, as a relatively recent specialty, is rapidly expanding across the globe, aiming to deliver prompt and suitable care to all patients in need.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?: 

Without exaggeration global EM has impacted every aspect of his practice. “Global EM has shaped every patient interaction I have – I’m working on trying to understand all the structural forces that brought a patient into the emergency department, no matter where in the world that might be”. He is also working to bring global health local – working on starting Canada’s first social emergency medicine elective at Vancouver general hospital – a unique learning experience to expose learners to the social determinants of health as they apply to emergency medicine and providing them with the tools to advocate for our most socially vulnerable patients. 

Have you done any focused training related to Global EM? During his residency Dr. Douglas-Vail completed a certificate in climate change and health at the yale school of public health. He has recently completed a fellowship in global EM at the university of toronto, as well as a diploma in tropical medicine through Medecins Sans Frontieres (Doctors without Borders). 

What projects have you been involved in that you would like to share?: Dr. Douglas-Vail’s fellowship projects are centered on the establishment of resource-limited point of care ultrasound training in Ethiopia and rural Liberia. 

What projects are you currently working on and would you like us to highlight any?: Currently he is really excited about Vancouver general hospital’s social emergency medicine elective and working on qualifying the tangible changes this will have on learners experience and advocacy. 

Tell me about one memorable city or country where you’ve worked?: Dr. Douglas-Vail recently returned from rural Liberia. He was working in a small town called Harper that requires you to fly in by bush plane. It was very different from his day to day shifts in Vancouver. Limited labs, no xray, no CT scanners. It required a lot of out of the box thinking and advocacy for patients. 

What are some unique challenges that you have faced while providing emergency medical care?: As in Canada, emergency medicine is grossly underfunded and understaffed. At the medical center he worked at in Liberia, there was no physical emergency department until a couple years ago. Patients were seen in makeshift, informal settings like a bench or the grass outside the obstetrics building. Thanks to the incredible advocacy of the Liberia physicians there is now a physical emergency department and dedicated staff with emergency care training. 

Twitter handle if applicable?: @MattDouglasVail

Any final comments? “Happy to chat about social emergency medicine and global health any time. People should feel free to reach out to me via email or twitter.”

Current faculty/position?: Emergency physician and soon to be trauma team leader at St. Michaels Hospital. 

Where are you currently located?: Toronto Ontario 

Where did you do your residency?: Dr. Myers did medical school in Ottawa and residency at the University of Toronto. In her 5th year of residency in partnership with the Northern Ontario School of Medicine and the Ornge Air Ambulance service she spent most of her time in Northern Ontario working in emergency rooms and nursing stations. 

Why is Global EM important to you?:  

Dr. Myers emphasizes the significance of global emergency medicine but holds a unique perspective that leans towards addressing local needs. While acknowledging the importance of global efforts, she believes there is crucial work to be done within her own country, Canada, specifically in northern Ontario where her family resides and where she has personal connections.

Having spent considerable time in northern Ontario and witnessing the disparities in resource and care access compared to larger cities like downtown Toronto, where she underwent training, Dr. Myers feels strongly about closing the gap in available resources for patients in the region. Her passion lies in ensuring equalized care for all Ontario residents, with a particular focus on improving healthcare opportunities for the indigenous population, who face significantly worse health outcomes and limited access to resources.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?: 

Dr. Myers finds her involvement in Global EM impacting her practice in several ways. While her core practice primarily revolves around serving the inner city population in downtown Toronto, her work in northern Ontario draws many parallels. Both populations face challenges in accessing resources, with the inner city dealing with marginalized individuals and the northern Ontario population facing geographic and sparsity-related hurdles.

Engaging in global work also enhances Dr. Myers’ clinical practice. Working in rural locations like northern Ontario requires a broader skill set, as medical professionals often need to manage more aspects of care independently. This experience not only improves her clinical abilities in her primary location of practice but also in the rural setting.

Moreover, Dr. Myers believes that her global involvement grants her valuable perspective when working as a trauma team leader. In this role, she receives patients transferred from rural areas. Her experience in global EM provides her with insights into the challenges that medical professionals in these remote locations face concerning resources and time constraints. Understanding their situations better helps her make more informed decisions when accepting transfers and ensures that she can provide the best possible care to these patients.

Regarding her career goals, Dr. Myers sees her involvement in Global EM as an essential component of her professional trajectory. Through this work, she aspires to bridge the gaps in healthcare resources and access for underserved populations, particularly in northern Ontario. This aligns with her dedication to equalizing care for all patients, regardless of their location or background. Her global EM experiences contribute significantly to shaping her career aspirations in a direction that emphasizes improving healthcare equity and quality for those in need.

Have you done any focused training related to Global EM? 

During her final year of residency, she took the initiative to create an informal fellowship. This involved spending several months working in various northern emergency departments and nursing stations under the guidance of experienced physicians. Additionally, she gained experience by accompanying the orange air ambulance service on medical evacuations in these northern settings.

As part of her commitment to cultural competency and understanding the needs of indigenous populations, Dr. Myers completed the Indigenous Cultural Competency Course, an online module. This course helped her gain valuable insights into providing better care to indigenous communities.

Furthermore, Dr. Myers is currently embarking on further educational pursuits to enhance her expertise in Global EM. She is about to start her Masters of Public Health program at Johns Hopkins, with a specific focus on addressing care disparities in northern Ontario. Through this program, she aims to develop projects and initiatives aimed at improving healthcare access and quality for underserved populations in the region. Her training and educational efforts reflect her dedication to making a positive impact in Global EM and addressing healthcare disparities on a broader scale.

What projects are you currently working on and would you like us to highlight any?: 

One of her current endeavors is focused on building a rural emergency medicine elective for the emergency medicine residents at the University of Toronto. This project is still in its early stages, but the aim is to establish a partnership with the Sioux Lookout Emergency Department. The goal is to provide the residents with more accessible and streamlined opportunities to undertake electives, whether for shorter or longer durations, thereby enhancing their exposure and experience in rural emergency medicine.

Furthermore, Dr. Myers is working towards formalizing the informal fellowship she initiated during her final year of residency. She plans to establish this fellowship in collaboration with Orange, the air ambulance service. By converting it into a formal fellowship, she aims to provide a more structured and organized learning experience for aspiring emergency medicine professionals, helping them gain valuable skills and insights while working in northern settings and nursing stations.

Through these projects, Dr. Myers demonstrates her commitment to advancing rural emergency medicine opportunities for trainees and promoting partnerships that facilitate valuable learning experiences in underserved regions. Her dedication to formalizing initiatives and improving training opportunities reflects her desire to contribute positively to the field of emergency medicine and address healthcare disparities in remote and rural areas.

Tell me about one memorable city or country where you’ve worked?: 

One memorable city where Dr. Myers worked is Deer Lake, located in northern Ontario, Canada. Before starting her fifth-year mini fellowship specialty program, she had the opportunity to travel to Deer Lake with a multidisciplinary team to provide assistance during a COVID outbreak.

During her time in Deer Lake, Dr. Myers and her team worked together to manage the COVID outbreak, providing essential medical support to the local community. Additionally, they helped catch up on a backlog of care that had accumulated due to the impact of the COVID outbreak on healthcare services.

The experience in Deer Lake was not only professionally rewarding but also culturally enlightening for Dr. Myers. It was her first time working in a nursing station, and the experience gave her valuable insights into the medical landscape and healthcare challenges in remote communities in northern Ontario.

One striking realization from her time in Deer Lake was that many communities in the region are only accessible by flight. This meant that all medical evacuations and resource deliveries were conducted via flight ambulances, underscoring the unique challenges faced by these remote communities. The experience left a lasting impact on Dr. Myers, highlighting the importance of addressing healthcare disparities and providing quality medical support to underserved regions.

What are some unique challenges that you have faced while providing emergency medical care?: 

One significant challenge is the need for a broader skill set compared to her experiences in large academic institutions. In urban centers, there is easier access to specialists, and patients are often referred for specific procedures. However, in rural settings, Dr. Myers has had to take more initiative and expand her skill set to be able to perform a wider range of medical procedures herself.

This required her to engage in additional self-directed learning to enhance her capabilities in handling various medical situations. Dr. Myers acknowledges the excellent training she received but emphasizes that in rural areas, medical practitioners must be more self-reliant and adaptable to handle a diverse array of cases.

Additionally, in rural settings, access to family physicians may be limited or non-existent for many patients. Consequently, the emergency room becomes a vital source of family medical care for these individuals. Dr. Myers recognized the need to broaden her skill set to include more family medicine competencies to adequately address the comprehensive healthcare needs of these patients.

Twitter handle if applicable?: @vrosem

Any final comments? Feel free to reach out to Dr. Myers to discuss potential collaborations, share ideas, or seek guidance on addressing healthcare disparities in rural communities.

Current faculty/position?

Clinical Assistant Professor, Department of Emergency Medicine, University of Calgary

Where are you currently located?

Calgary, AB

Where did you do your residency?

UBC Rural Family Medicine and U of C +1 EM

Why is Global EM important to you?

I really enjoy learning about different health systems. I like confronting the challenge of global EM and working with international partners towards a common goal. I believe that assisting developing academic EM departments and helping to build sustainable EM capacity in low and middle-income countries is a noble pursuit.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

I work full-time in the ER, but I spend a significant amount of time helping organize different global EM projects outside of my clinical hours. I don’t treat it like work though, because I enjoy it. To be honest, global EM doesn’t really fit any specific career goals for me at all. But I think variety is important to all of our careers, and the satisfaction I get from being involved in global EM keeps me excited about medicine.

Have you done any focused training related to Global EM?

No, I have not.

What current projects are you involved in or past projects that you would like to share?

Our department’s flagship project is the Calgary-Mbarara Emergency Medicine (CMEM) Collaboration. It is a partnership between Mbarara University of Science and Technology (MUST) in Uganda and the University of Calgary. EM is a new specialty in Uganda, and MUST started the first postgraduate emergency medicine fellowship in 2017. To help support their nascent program, our faculty travel to Uganda as visiting professors at the university and also work as consultants at the referral hospital. Recently, one of our faculty was accompanied by a pediatric EM fellow. This fall we are planning to host three Ugandan senior EM fellows for elective rotations in Calgary.

Tell us about one memorable city or country where you’ve worked? (or simply visited unrelated to work)

The most memorable places I worked were Johannesburg and Khayelitsha, South Africa. It’s a fascinating and beautiful country but has high rates of poverty and violence. The hospitals there were chaotic, but staffed by amazingly talented healthcare professionals who provided excellent care in challenging situations. I learned a lot.

What are some unique challenges that you have faced while providing emergency medical care?

It’s challenging to be faced with a patient where you know a specific treatment or intervention might save their life, but is unavailable. That scenario, luckily, is relatively rare in a highly resourced country like Canada, but is ubiquitous in the developing world.

What projects are you currently working on and would you like us to highlight any?

Mainly the CMEM collaboration.

Why is Global EM important to you?

Global health is important to me because its underlying goals resonate deeply: health as an intrinsic social good and health equity within and between populations. Because I’m fortunate to be trained in EM, one of the ways I engage with global health is through EM practice. I value the community of people that are engaged, supporting, and critical of the work that is done under the global health umbrella.

How does your involvement in Global EM impact your practice?

Every time I step into my scrubs, I encounter challenges and struggles that are shared among underserved and marginalized people and populations all over the world. Understanding that shared experience – whether it is someone experiencing homelessness in Canada or someone fleeing persecution abroad – is critical to working with the patient in front of me and informs efforts to create lasting, systemic changes.

Have you done any focused training related to Global EM?

I completed by emergency medicine fellowship at McGill University where I took a longitudinal certificate course in global health, led by Dr. Kirsten Johnson. I learned about approaches to humanitarian aid and international health. The course finished with a 3-day intensive humanitarian response simulation at Harvard.

Later on, I took another certificate course in tropical medicine at the Gorgas Memorial Institute in Peru where I developed some experience with infectious and non-infectious diseases.

After that I went back to school for a Master’s in health policy, planning and financing which formally introduced me to concepts such as universal health coverage, which are important for global health work, including global EM. I wrote my dissertation on the communication of climate change and health, which informs a lot of my current projects.

Beyond that, I have also benefited from a training course through MSF/Doctors Without Borders which taught knowledge and skills related to international humanitarian field work.

What past projects that you would like to share?

I helped to develop a health equity committee with a fantastic group in Toronto called Global Health Emergency Medicine (https://ghem.ca/). I worked as a consultant for MSF to examine the role of climate change on health in Central America. More recently, colleagues and I completed an economic evaluation of managed alcohol programs in Canada. MAPs are harm reduction strategies for people experiencing homelessness and severe alcohol use disorder. I also worked with a team of experts from across Canada to write a CAEP position statement on care for persons experiencing homelessness, which was part of the knowledge translation for a Canadian clinical guideline on homelessness. (https://link.springer.com/article/10.1007/s43678-022-00303-2).

Tell us about one memorable city or country where you’ve worked? (or simply visited unrelated to work)

It’s important to remember that global health isn’t about travel. In the context of wildfires burning across Canada (and the world), it’s best to make use of the many options now available for collaborating across borders when long-distance travel isn’t necessary. There are also many opportunities to take on global health projects closer to home.

Sometimes being in a place with your feet on the ground is critical to a project though, and I’ve had wonderful experiences in Addis Ababa as a faculty delegate for the Toronto Addis Ababa Academic Collaboration (TAAAC, https://ghem.ca/project/taaac-em/). I remember being met with enthusiasm for EM along with kindness and generosity from my hosts. I learned a lot from the residents and faculty I worked with. They had a deep knowledge base. Addis itself is a vibrant city and the surrounding regions were breathtaking (literally because of the altitude). I hope for  peace and good relations in Ethiopia in the near future.


What are some unique challenges that you have faced while providing emergency medical care?

I’m not used to feeling like I didn’t do enough. When I was working in a conflict affected area, I knew that some of my colleagues had actually trained abroad and then returned to their homes after the conflict started out of a sense of duty. They worked tirelessly – 70, 80, 90 plus hours a week. There was no sense of burnout, just a need to help as many people as possible. It’s startling to be in the presence of that kind of courage and dedication and knowing that after a few months I would get to fly home to the comfort of a nice apartment, the stability of a highly-paid job, and the freedom to walk outside without risking my life. That stark inequality is difficult to reconcile.

We see that sharp contrast in Canada as well, but it’s so easy to be inured to the inequality around us. My global EM experience serves as a constant reminder and challenge.

What projects are you currently working on and would you like us to highlight any?

I’m part of an academic network studying climate change and inequalities. I’m currently working with groups of other researchers to study climate change and poverty and also how public health systems address climate change. Our goals are to understand the structural and population-level impacts of climate change and how health systems can organize to address it.

I’m working with another group to study the effects of health care coverage, and lack thereof, on people without health insurance in Canada. It’s a complex issue, but again, one of the push factors for more and more migrants is that their homes are becoming uninhabitable because of environmental destruction, climate change and the exploitation and extraction that drives them. I’m very proud that CAEP supports making coverage for uninsured residents permanent and has called on the government to do so. It’s a highly principled position and important for our professional organization to take that stand for our patients and for our health care system.
https://caep.ca/wp-content/uploads/2023/03/OHIPcuts-March31.pdf

My PhD work is in a slightly different direction. I’m studying how well pharmacare programs protect people from financial hardship and which factors are associated with that hardship. Access to medicines is part of efforts to achieve universal health coverage and a recent Canadian study has shown lower health care costs overall by providing access to medications. Research has also shown that people sacrifice food, shelter and other necessities for essential medicines. I’m very concerned that in our cost-of-living crisis, more people could be forced to choose between a roof over their heads and their health. I hope that my research will promote equity by informing the design of our health and social care systems.

Current faculty/position?: 

Emergency Medicine physician Kingston Health Sciences, Assistant Professor, Queen’s University Transport Medicine Physician, Ornge

Where are you currently located?: 

 Kingston, ON

Where did you do your residency?: FM residency? 

McMaster University (Emergency Medicine)

Why is Global EM important to you?:

Emergency Medicine plays an essential role in universal health care. It acts as the safety net of a given country’s healthcare system. High quality emergency care is an important part of ensuring health equity, no matter the location. My involvement in Global Emergency Medicine focuses on capacity building, clinical care, and health systems strengthening within Ontario and globally.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?:

   I see my Global EM work as an extension of the work that I do locally, bringing together clinical work, education, research, and systems strengthening with the goal of providing equitable access to high quality EM care. When I’m working a shift in the emergency department or as part of the Ornge team to transport a critically ill patient from a remote community in Ontario, my focus is on patient level care; whereas I get to focus on systems improvement in my consultant roles internationally.

Have you done any focused training related to Global EM?

   Global Emergency Medicine Fellowship, Queen’s University

What current projects are you involved in or past projects that you would like to share?:

  I’ve been fortunate to get to work on a variety of projects – from teaching prehospital care in Libya, clinical mentoring in DR Congo, Laos, and Uganda, to Emergency Department assessments and strengthening in Georgia.

Tell us about one memorable city or country where you’ve worked? 

Libya was the first long term position that I had overseas. While memorable for many reasons, the day I woke up to a pile of sand under my bedroom window (inside – from a sand storm), was definitely a first!

What are some unique challenges that you have faced while providing emergency medical care ?

My first teaching trip was planned to be a training course for Paramedic staff in Cambodia to support land-mine clearance activities. When we arrived to deliver our powerpoint teaching sessions in an indoor training facility, it turned out to be an empty field in a remote area. We quickly pivoted the sessions into hands-on teaching sessions and our field exercises included the odd stray cow and chicken spectators.

What projects are you currently working on and would you like us to highlight any?

  In addition to lots of local ED work, I’m currently working as a consultant for the WHO on a project to strengthen Emergency Department systems in a new department in Moldova. 

Name: Susan Bartels

Current faculty/position?: Associate Professor, Canada Research Chair in Humanitarian Health Equity (Tier II)

Where are you currently located?: Queen’s University

Where did you do your residency?: FM residency? I did FRCPC Emergency Medicine training at Queen’s University.

Why is Global EM important to you? Global health work is important to me because it addresses social justice and historical inequities. It is also a way for me to give back to the community, which feels right, given that I come from a position of relative privilege.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?:

I try to emphasize a holistic approach to individual care in my clinical work and global health work. With my strong interest in the social determinants of health, be it vulnerable housing, identifying as racialized, substance misuse disorder, interpersonal violence, or inability to pay for prescription medications, I try to pay attention and consider these factors when developing treatment and management plans. In addition to learning core medical and public health content, trainees must learn how to advocate for their patients.

Have you done any focused training related to Global EM? Yes, I went to Boston post-residency and did a two-year Global Emergency Medicine Fellowship at Brigham and Women’s Hospital and a Masters of Public Health at the Harvard School of Public Health.

What current projects are you involved in or past projects that you would like to share?: Much of my work is research examining how humanitarian crises, including armed conflict, forced displacement, and disasters, impact individuals and communities. My particular focus is women and children. I always work closely with local partner organizations who help to identify the research priorities and provide the cultural, contextual, and linguistic expertise, which is critical. Using a human rights and equity lens is important to me.

Our team has previously researched child marriage within the Syrian crisis by working with a partner organization in Lebanon, the ABAAD Resource Centre for Gender Equality. We have also investigated sexual exploitation and abuse perpetrated by UN peacekeepers in Haiti (in partnership with BAI, KOFAVIV, and the ETS School of Social Work) as well as in the Democratic Republic of Congo (partnering with SOFEPADI and Marakuja). Last year, we partnered with the International Organization for Migration to examine the gendered risks faced by female Venezuelan refugees and migrants in Ecuador, Peru, and Brazil.

Tell us about one memorable city or country where you’ve worked? I remember the first time I went to Bukavu, in the eastern Democratic Republic of Congo. I was traveling with a North American colleague, and we were working at Panzi Hospital, founded by the Nobel Prize laureate Dr. Denis Mukwege. In a conversation with another North American colleague who had never been to Bukavu, I described Bukavu as picturesque, with bustling markets, rich culture, and breathtaking views over the lake, especially during sunrise and sunset. In contrast, the colleague I was traveling with described it as muddy, crowded, and impoverished. None of those things were untrue, but I guess it all depends on perspective and what you choose to see… I still think Bukavu is lovely!

What are some unique challenges that you have faced while providing emergency medical care? 

I no longer provide much clinical care in my global health work, but I would like to highlight one aspect of international work. That is our reliance on implementing partners who understand the culture and context and have the linguistic skills to communicate with local community members. Without those partnerships, the work I do wouldn’t be possible. Therefore, investing the time and energy to build and maintain those collaborations is pivotal.

What projects are you currently working on, and would you like us to highlight any?

We have a new project coming up later this year that I’m excited about. It involves geo-messaging, a platform that merges text and voice messaging, geospatial information, and analytics into a single user-friendly dashboard to orchestrate bi-directional delivery of specific geo-coded data when and where people need it. I like that this technology can empower refugees/migrants to have their voices heard directly and to communicate their own needs. The geo-messaging platform will be used within the Venezuelan migration crisis in collaboration with iMMAP to determine whether it provides more geographically specific, accurate, timely, and actionable data from a humanitarian response perspective. The New Frontiers in Research Fund funded this project, and it will be implemented in collaboration with fellow CAEP members and Queen’s colleagues, Drs. Amanda Collier and Jodie Pritchard.

Current faculty/position?: ER physician at North Bay Regional Health Centre

Where are you currently located?: North Bay, Ontario

Where did you do your residency?

Medical school at Universidad Iberoamericana (UNIBE). CCFP residency at the University of Ottawa, rural program with North Bay as a home base. Fellowship at the University of Toronto. 

Why is Global EM important to you?

To me it’s the same answer as why is medicine important to you. It doesn’t matter where you’re doing it; the service of helping people, the love of science, as well as the ethical and moral principles feeding it are some reasons why I enjoy medicine. For me personally, having patients who are on the brink of life and death, on the precipice, is the most challenging and satisfying part of medicine. As much as I love doing it here, I love providing that kind of care in countries where they don’t have that option. It’s even more rewarding when you know you are helping that population by helping their doctors and aligning their resources to what we would have here. Populations in need are always going to be present, the question is how much of yourself are you going to give. I have had a lot to give because I have had a lot given to me. It doesn’t hurt to share that fortune. 

How does your involvement in Global EM impact your practice? How does it fit into your career goals?

When I first started, I would come back to Canada and people would ask me “how does it feel to work here with our first world problems?” The way I see it, people come to the ER because the issue they have is serious to them. This is their context; they don’t have the same point of reference that people in other parts of the world do. Working with MSF has greatly helped my practice here. What we do in North America is excellent, but not always the best thing. Working abroad has allowed me to learn from other countries and how they practice medicine based on the evidence and its practical application. It has definitely made me a better physician. However working for MSF also didn’t stop me from ordering tests here simply because others did not have it – this is dependent on the context we live in. I have those resources available to me here, and so I use them. 

Have you done any focused training related to Global EM?

I received ACLS and ATLS training before going on missions. Going on missions allows you lots of opportunities for focused training. I became a subject expert in chemical and biological weapons along with decontamination, as well as mass casualty planning and events. I also became an expert on blood banks, blood transfusions and cotrain transport, which is how to transport resources to deliver care. I received MSF training on infectious diseases and outbreak training. I also built an XR room, which involved learning how to set up a room that was safe, as well as learning how to process and interpret the films, along with subsequent treatment options. I will give a shoutout to Aruyan Sail, who runs a cast it course for physicians in North York. I reached out to him, and he designed a cast it course for MSF for free. He shared knowledge with people who would have had no idea what to do upon reading these films. 

What current projects are you involved in or past projects that you would like to share?

I previously took a break from MSF to become the Chief of Emergency Medicine at North Bay Regional Health Center. I have stepped down from this position recently, and am hoping to do more Canadian based work, such as with a board of directors.

Tell us about one memorable city or country where you’ve worked?

I would say Iraq had the biggest impact on me. They are the most appreciative and proudest population that I’ve ever met. These people went through things you think can’t possibly be real, things more intense than you realize. Iraq was where I saw my first chemical weapons victim. It really impacted me, especially when they’re so young. It’s not a movie or a story, but a real person right in front of you. As well, in this mission I had a lot of independence. I set up a blood bank system and a pharmacy, including the creation of a clear supply chain. I also assisted in setting up an OR and labor and delivery unit, as well as helped run an ambulance service. It was an incredible amount of work, but so many Iraqis that wanted to make it happen that they would do anything they were asked in order to push it through. It was very inspiring, and I got to see humanity at its finest in the worst situations.

What are some unique challenges that you have faced while providing emergency medical care?:

A unique challenge that I faced was setting up medical systems in other countries that we take for granted here, including blood banks and ambulance services. I also assisted in setting up trauma stabilization points, which was extremely challenging. The goal is to have trauma services as close to the injured as possible. They have to be accessible to patients, without putting yourself too much at risk. Setting up these trauma stabilization points have been shown to save lives, and have a huge impact on survival. However doing this in a dynamic environment is the most challenging thing. As the front line moves, you have to move with them. Figuring out what equipment you need, how to follow the front line around, and where to place your equipment takes a lot of knowledge and strategy. 

Current faculty/position?: Retired

Where are you currently located?: Edmonton, Alberta 

Where did you do your residency?: Medical school at the University of Alberta. CCFP residency at the University of Calgary.

Why is Global EM important to you? In Canada, something we did right from the inception of emergency medicine is that we made it a 24 hour, 7 day a week, 365 day a year specialty. As such, there has to be a qualified EM physician in the emergency room all the time. At no point should we leave it up to the learners, which is what happened in the USA, and continues to happen in many other specialties even now in the off hours. The concept of emergency medicine always being there to serve the needs of the population is universal, as there is nowhere in the world that doesn’t need this. Working in different countries and working on getting that system built elsewhere is very important to me.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?: I don’t believe that it’s impacted my practice much. Part of the challenge in Canada is that we are so weighed down with bureaucracy that we lack efficiency. It was therefore difficult to incorporate things from Taiwan in Canada. For example, in Taiwan they had two cardiology services: cardiology 1 and cardiology 2. Here, whoever gave the best service got the patient. I was interested in incorporating something like this, however we are told we can’t do things in public institutions that we can do in private institutions, which I don’t agree with. You can still build incentives within a public system.

Have you done any focused training related to Global EM?: A lot of lived experience. I attended lots of global health conferences, and met others with similar ideas and experiences. Before going to Taiwan I spent 1 month in Toronto speaking with the residency coordinator there, in order to get an idea about his training program. I also went to Portland and Denver as they had good training programs as well. I then built a training program in Taiwan based on those programs.

What current projects are you involved in or past projects that you would like to share?: In Taiwan I got into building information systems, as the only way to protect the department of emergency medicine from other services was to capture all the data when the patient arrived. We captured the diagnosis, who we consulted and when, how many hours the patient was admitted, among other things. We then used this information to advocate for emergency medicine. When we spoke with the superintendent regarding how the consultant takes 9 hours to come, and they don’t admit patients in 12 hours as they say they do but rather 24, we had the data to prove it. This allowed the problem to get fixed. 

When I got back to Canada, I built clinical decision support tools. When CTAS first existed, it was subjective rather than objective. To solve this, I met with a handful of RNs where we worked to define 69 complaints. We also wrote definitions for terms like shock and hemodynamic instability. From this, we then built the clinical decision support tools, which were used in Edmonton. We took what we learned to CTAS, and using those findings were able to rebuild CTAS into a more objective tool. CTAS is based on complaints only, not diagnoses, as it’s not the triage nurses responsibility to diagnose someone. We then took CTAS to Taiwan, where previously they used a 4 level scale, with some diagnoses and some complaints. It was easy to introduce here, because of the connections I had made previously. We then built the methodology for introducing it across the world, in order to introduce it to even more countries. 

Tell us about one memorable city or country where you’ve worked?: I put the most work into Taiwan, with the greatest gratification being that we were able to get emergency medicine declared as a speciality. 

South Africa was also memorable, as I performed craniotomies, a variety of abdominal surgeries, mastoidectomies for chronic mastoiditis, 50+ C-sections under epidural block (placed by myself), numerous skin graft for deep and often extensive burns, and I was the primary orthopedic surgical provider. I was also in charge of the adult male and female medical and surgical wards, generally responsible for 150 inpatients, including the infectious disease ward. I also often provided anesthesia for Penny, the Medical Director, with whom I was partnered for our every 2nd night and every 2nd weekend call schedule. We had no lab, only a microscope and various stains to help identify infectious agents. We had excellent basic x-ray capabilities. We had a limited but effective pharmacy for what we needed. I saw over 2000 cases of TB during the 9 months I was there, but fortunately this was before the AIDS epidemic which didn’t hit until the late 80s. 

What are some unique challenges that you have faced while providing emergency medical care? The biggest challenge is going into a different culture, where there is a different mindset. IN Taiwan, the learning process is rote memorization rather than problem solving. This was a huge challenge in the ER. I took 30 important and common ER conditions and wrote 30 different case scenarios where I worked through the entire presentation of the patient, from start to finish. All of the cases had a number of key points that had to be learned in order to understand how to manage each patient presentation. Another part was teaching the concept of teamwork, as they were just individuals. In Chinese culture they dilute individual rights, and instead focus on collective rights. They don’t want to stand out above the crowd, which makes it a challenge to get leaders to identify themselves. 

Current faculty/position?: 

Queen’s University and University of Ottawa Departments of Emergency Medicine

Where are you currently located?: 

Ottawa

Where did you do your residency?: 

University of Ottawa 

Why is Global EM important to you?:

To me, Global EM is about equity – striving for a world where everyone gets the same the healthcare no matter where they live.  I grew up in rural Canada, and in some cases, it can be just as hard (or harder) to get specialized care there as it is in lower resource settings halfway around the world.  Global EM is about trying to move the needle towards equitable healthcare for all – in Canada and around the world.

How does your involvement in Global EM impact your practice? How does it fit into your career goals?:

It changes your perspective.  Working in different settings helps me appreciate my home practice when I return.  Things like waiting a few hours to get a CT scan, or for a specialist to call you back just don’t seem as frustrating after working somewhere where the patients had to walk for hours or days to see you.  The change also helps prevent burnout by giving me time to experience something new, and then reset when I come home.  On a practical level, it takes some balancing to work enough shifts at home while scheduling time working out of the country.

Have you done any focused training related to Global EM?

I completed a diploma in Tropical Medicine and Hygiene (LSHTM), a fellowship in Global Emergency Medicine (Queen’s University) and a Master of Public Health (JHSPH). 

What current projects are you involved in or past projects that you would like to share?:

In the past, I have worked in Dominica following Hurricane Maria, provided primary care in several communities in Tanzania and worked in the Kutupalong refugee camp in Bangladesh.  More recently I’ve focused on teaching and capacity building, and have taught emergency medicine skills in Bangladesh, Haiti and Ethiopia. 

Tell us about one memorable city or country where you’ve worked?

Every place is memorable – the people you meet, the beauty of a landscape – the food!  Most recently I work in Eastern Ethiopia. The city Harar is an old walled city, full of beautiful buildings.  It is also famous for some families having ‘domesticated’ hyenas, which tourists can visit and sometimes even feed.  I was much closer to a hyena than I ever wanted to be. 

What are some unique challenges that you have faced while providing emergency medical care? 

Every day brings different challenges.  Often you don’t have the equipment or resources to provide the level of care that you would like to provide, and you need to adjust your expectations (while providing the absolute best care you can).  We have to be creative to find solutions.  For instance, I’ve taught neonatal resuscitation skills using a teddy bear from a local market, or run outreach clinics in a school.

What projects are you currently working on and would you like us to highlight any?

I am currently the lead for a collaboration between Queen’s University and Haramaya University to build capacity in eastern Ethiopia in the region around Harar.  Several specialities are collaborating with Haramaya University to support residency training and QI projects.  Canadian physicians travel to Harar to help teach the residents – anyone interested in teaching please contact me!