IFEM GWU,USA

Urgent opening with leading Aviation Company for Flight Physician_Riyadh(Saudi Arabia)

2011-09-17T21:27:00.000-07:00

Experience required for the Job: 2 - 8 years

Job Location: Saudi Arabia

Dear Candidate,

Urgent opening with leading Aviation Company for Flight Physician_Riyadh(Saudi Arabia)

Designation: Flight Physician Emergency Medicine
Job Location:Riyadh(Saudi Arabia)
Qualification: MBBS, MD or DO degree.

Job Description: Provides, supervises, and manages patient care of beneficiaries to include flying and special operational duty personnel. Examines, diagnoses, and treats initial & acute phase of illnesses and injuries. Directs emergency & related patient services.

Job Prerequisites:
â€¢ Must be graduated from a recognized medical school possessing MBBS, MD or DO degree.
â€¢ Post graduate professional experience of 2 or more years is preferred.
â€¢ Must be verified with letter of employment from previous employers
â€¢ Fluent in English, both written and spoken, Arabic is advantage
â€¢ Computer literacy level is required, proficient is preferred
â€¢ Fellowship of Royal College of U.K. or Republic of Ireland, American Board, Canadian Board, Fachartz (Germany), Scandinavian Board Qualification or the internationally recognized qualification, Arab Board or Saudi Board in Emergency Medicine.
â€¢ Current valid certifications in the following:-
o Basic Life Support
o Pre-Hospital Trauma Life Support (PHTLS) or equivalent (ITLS)
o Advanced Cardiac Life Support (ACLS)
o Pediatric Life Support (PALS)
â€¢ Current valid license to practice license to practice Medicine recognized by the Saudi Council for Health Specialties.

Benefits:
â€¢ (2 years) renewable contract
â€¢ Vacation: 30 days every year.
â€¢ Round trip air ticket to domicile every year.
â€¢ Private accommodation in a compound with social facilities
â€¢ Health insurance

If you are interested kindly send your CV as soon as possible.

(vrindaconsultants@gmail.com, Sec-27, NOIDA, Uttar Pradesh - 201301)

MOH(MINISTRY OF HEALTH) K.S.A medical doctor jobs

2011-09-16T23:27:00.001-07:00

Experience required for the Job: 2 - 30 years

Annual Salary of the Job: 0.0 - 30.0 Lacs

Job Location: Saudi Arabia

Dear Dr
As per our your CV in our leading database.Please find the below mail for the position with MOH(MINISTRY OF HEALTH) K.S.A

We would like to introduce ourselves as Habsons Jobsup Ltd., a leading international recruitment consultancy duly approved by the Ministry of Labour, Government of India providing overseas recruitment services for over a decade. We specialize in the recruitment of Medical / Healthcare professionals to Gulf countries.

MOH(MINISTRY OF HEALTH)
Kingdom of Saudi Arabia

Required Doctors
S. No Position Qualification Experience / Skils
1 All Medicine Department West Degree / MD/MS/MBBS 2 years exp in relevant department
2 All Surgery Department West Degree/ MD/MS/MBBS 2 years exp in relevant department
3 All Radiology Branches West Degree / MD/MS/MBBS 2 years exp in relevant department
4 All Pathology Branches West Degree / MD/MS/MBBS 2 years exp in relevant department
5 All Dentistry Branches MDS/BDS 2 years exp in relevant department
6 Critical Care West Degree / MD/MS/MBBS 2 years exp in relevant department
7 Emergency West Degree / MD/MS/MBBS 2 years exp in relevant department
8 G.P MBBS 2 years exp in relevant department
9 Resident Physician MBBS 2 years exp in relevant department
Salary: Commensurate with qualification and experience as per the pay scale of Ministry of Health Saudi Arabia, KSA

Benefits offered include: Monthly Tax Free Salary. Housing and Furniture allowance. 35-45 days annual paid holidays. Annual return air tickets to the country of permanent residence to the Doctor and family. Medical/Insurance coverage according to State health regulation and end of contract gratuity etc.

Interview Schedule are as Follows-Delegates will be coming to INDIA for the interview which are starting from 14th September 2011 at the following Location
â€¢ New Delhi
â€¢ Kashmir(Srinagar)
â€¢ Hydearbad
â€¢ Bangalore
â€¢ Mumbai
â€¢ Cochin
â€¢ Kolkata
Send your updated resume and confirmation by email to:kamna-npd@habsons.net
NOTE:
While coming for the interview, please carry the following documents in original and photocopy.
1. Your updated resume / bio-data
2. All Educational certificates
3. All Experience certificates
4. Passport - New & Old (If any)
5. Passport size colour photographs (Six)
6. Other relevant documents related to research work, publications, training, workshops and seminars attended
by you in your area of expertise.

A REQUEST TO ALL OUR CANDIDATES
You are kindly requested to inform your friends and colleagues if they have not applied so far and are interested for the above mentioned categories, they can also apply for the same

Your early response is highly appreciated. For any query please feel free to contact the undersigned.

Warm Regards
Kamna Mehta
Recruitment Coordinator
Habsons Jobsup Ltd.
1/1 A,3rd Floor
Bharat Nagar,New Friends Colony
Behind Mata Ka Mandir
New Delhi-110025
Mob: 9717599255, Phn: 011-26842805/6/7
Email: kamna-npd@habsons.net
www.habsons.net

Urgent Opening Doctors -MOH

2011-09-16T23:24:00.001-07:00

Habsons Jobsup Limited, hiring for Ministry of Health-KSA

Summary

Experience:

3 - 8 Years

Location:

Saudi Arabia

Compensation:

Rupees 3,00,000 - 8,00,000

Education:

UG - MBBS - MedicinePG - M.S/M.D - Any Specialization

Industry Type:

Medical/ Healthcare/Hospital

Role:

Opthamologist

Functional Area:

Healthcare, Medical, R&D

Posted Date:

10 Sep

Job Description

The Doctor must have Min 2 Years of Exp after the completion of Bachelors/Masters/Fellowship.. He/she should be from clinical background.

Keywords: Doctor, resident, Medical officer, consultant, specialist

Desired Candidate Profile

The Doctor must have Min 2 Years of Exp after the completion of Bachelors/Masters/Fellowship... He/she should be from clinical background.

Company Profile

We would like to introduce ourselves as Habsons Jobsup Ltd., a leading international recruitment consultancy duly approved by the Ministry of Labour, Government of India providing overseas recruitment services for over a decade

Contact Details

Company Name:

Habsons Jobsup Limited

Website:

http://www.habsons.net/

Executive Name:

Ms Kamna Mehta

Address:

Not Mentioned

Email Address:

engr@habsons.net

Telephone:

9717599255

Reference ID:

HAB/DOC/MOH

Plant Doctor - Medical Officer : Emergency Medical Services

2011-09-16T23:22:00.000-07:00

HR Professional Service Institute

Experience:

5 - 10 Years

Location:

Mohali

Compensation:

Rupees 5,00,000 - 15,00,000
+ Other long term benefits as per company policy + Travel / Conv. allowances.

Education:

UG - MBBS - MedicinePG - M.S/M.D - General Practitioner

Industry Type:

Oil and Gas/ Power/Infrastructure/Energy

Role:

Medical Officer

Functional Area:

Healthcare, Medical, R&D

Posted Date:

10 Sep

Job Description

Maintain, update, audit, implement & Train Emergency Medical preparedness at Plant Locations in Punjab - Rural locations and at HO in Mohali. Procure, maintain inventories of First Aid medical items. Tie up with Local Hospitals. Train Nurse at Sites

Keywords: Doctor, Medical Officer, MBBS, Plant Doctor, Plant Medical Officer

Desired Candidate Profile

MBBS / MD + Min 3 yrs Exp. in Emergency in a Good Hospital. Fully aware of Medical Emergency rqmts. and Preparedness needed to handle an emergency in rural Plant site location. Able to maintain good relations with Local Hospitals & Villages people.

Company Profile

Our client is a innovative Bio Fuels based Power Plants developing Consulting company settling up Plant at Rural Locations in Punjab / India. Desired candidate is an Emergency Medical Services trained. Send CV & Call personally to discuss further!

Contact Details

Company Name:

HR Professional Service Institute

Website:

http://www.hrps.us

Executive Name:

Pawan 9814465170, 0172-4648170

Address:

HR Professional Service Institute
S.C.O 359 -360
Sector 35 B
CHANDIGARH,Chandigarh,India

Email Address:

hrps12@gmail.com,hrps1@airtelmail.in

Telephone:

91-172-3013310

Reference ID:

HRPS/ 11/ 09/ Plant Medical Officer/ MBBS / MD

EKG FOR ACLS

2011-04-12T21:55:00.000-07:00

EKG Examples

REQUIREMENT - HEALTHCARE & PARAMEDICAL STAFF - SAUDI ARABIA & QATAR

2009-11-12T04:52:00.000-08:00

SAUDI RED CRESENT AUTHORITY, SAUDI ARABIA :

CONSULTANTS :
Branch : Emergency / ICU, Trauma / Casualty
Qualification : Western Qualified / DM / M.Ch / FRCS / MRCS with minimum 2 years experience in related area.
Salary : SR 20,500 Plus Accommodation / HRA

SPECIALISTS :
Branch : , Emergency / ICU, Trauma / Casualty
Qualification : MD / MS / DNB / MDS with minimum 2 years experience in related area.
Salary : SR 15,000 Plus Accommodation / HRA

RESIDENTS :
Branch : Medicine, Surgery, Radiology, Pathology, Anesthesia / ICU, Emergency / ICU, Trauma / Casualty
Qualification : MBBS with minimum 2 years experience in related area.
Salary : SR 9,500 Plus Accommodation / HRA

PARAMEDICAL STAFF :
Branch : Emergency Service / First Aid Providers
Qualification : PhD / MSc / BSc / GNM / DMLT with minimum 2 years experience in related area.
Salary : Based on Experience, Qualification & Field.

HOW TO APPLY :

Please contact us on 09825614820 for further details and send us your following details at the earliest on jobsfountain@in.com

1. CV / BIODATA / RESUME in MS-Word attachment
2. Scanned Documents in JPG Format at the earliest -
â€¢ Passport Size Photograph
â€¢ Passport (First & Last Page)
â€¢ Educational Sertificates
â€¢ Registration Certificate
â€¢ Experience Certificates
â€¢ Appreciation / Achievement Letter

SERVICE CHARGE :
Service Charge Applicable and Candidate has to Pay after getting the VISA & AIRTICKETS.
With Best Regards,
Shailesh Gautam
JOBS FOUNTAIN
0 9825614820
Email : jobsfountain@in.com

Resident-Emergency (2-5 yrs.) Fortis Healthcare Ltd

2009-10-27T07:31:00.000-07:00

A leading healthcare co. having offices/units all over India with its corporate office in New Delhi.Healthcare Delivery Organisation driven by quality, excellence, technology and research and to fulfill this vision through a
Designation Resident-Emergency
Job Description
1.1. To practice emergency medicine in an ethical manner consistent with contemporary emergency medicine principles.

1.3. To maintain current emergency medicine knowledge and skills through independent study and continuing medical education activities.

1.4. To exhibit professionalism in the ED in regard to behavior, attire and reliability. To discuss problems with consultant. To assist with review of patient's medical records as part of quality assurance studies. Gather data for quality assurance studies. Actively participate in presentations of CME’s and Journal clubs.

1.5. To complete patient history form, visit patient and review medical record. Obtain relevant clinical information for inclusion in report of all irregular antibodies and transfusion reactions. Record and evaluate all acute transfusion reactions with patient/medical record review. Assist the consultants in all emergency cases.

1.6. To participate in medical staff and/or hospital affairs with the support of the ED medical director. Make special recommendations wherever needed.

1.7. To gain knowledge of the basic principles of documentation, coding and reimbursement, recruitment costs, coding and billing costs, practice expense costs and other applicable physician administration costs to assist in accurate billing for their services and to properly interpret practice revenue and expense information which they receive.

1.8. To maintain knowledge of and compliance with existing laws.

1.9. Supervise all nursing/ para medical & non medical staff of the department to maintain discipline and high standard of medical care at the department as per standard operating procedure.

Desired Profile
mbbs with exp in ER

Experience 2 - 5 Years
Industry Type Medical/ Healthcare/Hospital
Functional Area Healthcare, Medical, R&D
Education UG - MBBS - Medicine
PG - Post Graduation Not Required
Compensation: best in the industry
Location Delhi/NCR
Keywords Emergency
Contact HR
Fortis Healthcare Ltd
B-22,SECTOR-62 NOIDA
NOIDA,Uttar Pradesh,India 201301
Telephone 91-120-2400222
Website http:// or https:// www.fortishealthcare.com
Job Posted 23 Oct

Doctors IN Emergency

2009-10-21T04:50:00.000-07:00

Location:Eastern Province ,Al Madina Al Munawarah ,Jeddah

Key Skills:Emergency/Casuality Experience Specialization:Emergency MedicineJob Function:Doctors/Nurses/Medical ProfessionalIndustry:HealthcareQualification:Post Graduation -
Any Post Graduate

School & Graduation -
MBBS (Medicine )
Level:Junior - Executive, AssistantExperience: 2 - 7 yrs. Job Details:
Please see the attached requirement. If you find suitable for any of these categories, contact us immediately
1) SAUDI RED CRESCENT AUTHORITY
EMERGENCY RESPONSE SERVICES
(TRAUMA AND CASUALTY)

DOCTORS IN EMERGENCY FIELD
CONSULTENTS,SPECIALISTS& RESIDENTS
(MD/DND/MS/DM/MRCP/M.ch/PhD/MRCS)
.NEURO SURGEONS .ORTHOPAEDIC SURGEONS .GENERAL SURGEONS
.CARDIO THORACIC SURGEONS .PADIATRIC SURGEONS .UROLOGIST
.INTERNAL MEDICINE .GASTROENTERIOLOGIST .CARDIOLOGIST
.RADIOLOGIST
General Practitioners with MBBS degree and minimum 2 years experience after internship in above Specialties can apply as Resident Doctors.

EMERGENCY SERVICES PROVIDERS (PARAMEDICS)

A-FIRST Aid Providers with HSC+Diploma in Emergency Services- First Aid.
B- Male Nurses having Diploma in Nursing &Diploma in Emergency Services-First Aid.
C-Emergency Services Providers with Special training & Diploma/Certificates in the Sector which is Medical, Police, Fire, Sports, Catestrophe, Natural Calamities& Disasters

EXELENT SALARIES ,BENEFITS, AND FACILITIES

CONSULTANTS
Basic SR.18000/-
SR.1000/- Exp.
5% of Basic (Job Allowance) SPECIALISTS
Basic SR,12500/-
SR.800/-Exp.Allowance
10% Of Basic (Job Allowance)RESIDENTS
Basic SR.7000/-
SR.700/- Exp.Allowance
15% of Basic(Job Allowance) PARAMEDICS
Basic SR.7000/-
SR.700/- Exp.Allowence
20% of Basic (Job Allowance)
Selected Candidates Will also be eligible for SR.700/-per month as transportation allowance,
3 salaries per year as H.R.A Family status (For Doctors), Annual Vacation with paid leave and return air ticket and free medical facilities etc.Rush immediately your complete CV by courier / email (Emails only in word format without scanned attachment) within 7 days starting your contact nos. / Mobile no to:
,
Short listing in Progress..Contact us immediately Send your C.V to redcrossdoctors@gmail.com .

St. Mary s Consultancy,
1/5th Cross, Opp. Fairland,
Ejipura Main Road,
Viveknagar Post,
Bangalore 47
Mob: 09342576642, 09242917053
Email: redcrossdoctors@gmail.com

ALSO.......
required for ministry of health govt of Oman,
MEDICAL OFFICER DOCTORS (need 10.nos) IN ACCIIDENT & EMERGENCY (Salary: 425.RO per m

Registrar - Emergency Medicine

2009-10-17T21:41:00.000-07:00

Experience: 3 - 6 Years
Location:Saudi Arabia
Education:UG - MBBS - Medicine
PG - M.S/M.D - Other
Industry Type:Medical/ Healthcare/Hospital
Functional Area:Healthcare, Medical, R&D

Job Description
MINISTRY / GOVERNMENT AIDED HOSPITALS IN DAMMAM,RIYADH,JEDDAH,QASSIM & ABHA - SAUDI ARABIA Urgently Requires: Ph.D / Recent Fellowship / Master Degree in the Subspeciality with 3 years experience
Emergency Medicine, Ph.D / Fellowship / Master Degree
Desired Candidate Profile
MINISTRY / GOVERNMENT AIDED HOSPITALS IN DAMMAM,RIYADH,JEDDAH,QASSIM & ABHA - SAUDI ARABIA Urgently Requires: Ph.D / Recent Fellowship / Master Degree in the Subspeciality with 3 years experience
Company Profile
A Leading Healthcare Hospital in Saudi Arabia
Contact Details

Company Name:
A Leading Healthcare Hospital in Saudi Arabia

Website:
http://www.jerryvarghese.com/applyonline

Executive Name:
Mr. JAINUL ABUDEEN

Address: Not Mentioned

Email Address:
netsourcing@jvi-global.com

Telephone:
61451530

Reference ID:
Registrar - Emergency Medicine

Doctors Required for Abu Dhbai - A & E - SPR (4 - 9 yrs)

2009-10-05T08:45:00.000-07:00

Doctors Required for Abu Dhbai - A & E - SPR (4 - 9 yrs)
HCL International

Location: Abu Dhabi

Key Skills: "Accident & Emergency", "A & E", "A&E", ACCIDENT, EMERGENCY, TRAUMA
Specialization:
Accident & Emergency
Job Function:
Doctors/Nurses/Medical Professional
Industry:
Healthcare
Qualification:
Post Graduation -
MD/MS (Emergency Medicine )
School & Graduation -
MBBS
Level:
Middle - Manager, Assistant Manager
Experience:
4 - 9 yrs.
Job Details: Provides assistance to the Consultants in their department in all procedures as required
Maintains proper patient care in their area of service (e.g. medical, surgical, pediatric, ICU, ER) under the supervision of their respective Consultants and Senior Registrars
Shares the on-call schedule in the department as required
Attends departmental rounds
Participates in hospital symposia and specialist meetings
Performs other applicable tasks and duties assigned within the realm of his knowledge, skills and abilities
Observes the By-laws and adheres to the policies and procedures of the institution
Conducts research appropriate to his field
Responsibilities specific to each department as outlined by each department
Responsible with the consultant staff for the supervision of House Officers
Chiefly a service responsibility with education as secondary
May discharge uncomplicated cases without attending consultant
Writing of prescriptions
Certification of death
Patients seen in Emergency Room to be discussed with attending Consultant if complicated or unstable
Company Details:
One of the leading global consultant.
Contact Details:
Phone : 079 6609952

ER DOCS

2009-09-26T05:55:00.000-07:00

EMERGENCY MEDICINE (3 - 8 yrs)
Nitin International

Location: Kuwait City

Key Skills: MD IN EMERGENCY MEDICINE

Specialization:
emergency medicine
Job Function:
Doctors/Nurses/Medical Professional
Industry:
Healthcare
Qualification:
Post Graduation -
MD/MS (Emergency Medicine )
School & Graduation -
MBBS
Level:
MD EMERGENCY MEDICINE
Experience:
3 - 8 yrs.
Job Details: Emergency medicine is a medical specialty in which a physician receives practical training to provide patients with acute illnesses or injuries which require immediate medical attention. While not usually providing long-term or continuing care, emergency medicine physicians diagnose a variety of illnesses and undertake acute interventions to stabilize the patient. Emergency medicine physicians practice in hospital emergency departments, in pre-hospital settings via emergency medical service, other locations where initial medical treatment of illness takes place, and recently the Intensive-care unit. Just as clinicians operate by immediacy rules under large emergency systems, emergency practitioners aim to diagnose emergent conditions and stabilize the patient for definitive care.
Company Details:
We would like to introduce ourselves as one of the reputed Manpower Consultant, catering to the requirements of manpower needs in the Middle East. Having 30 years experience in the same field, working independently since 1993. We are approved both by the Government of India and Royal Embassy of Saudi Arabia, New Delhi as manpower consultant. Our agency is also approved by IATA (INTERNATIONAL AIR TRANSPORT ASSOCIATION) for the sale of International and Domestic Air Tickets. We are also the authorized agents of INDIAN AIRLINES, JET AIRWAYS, and SPICEJET & AIR DECCAN for sale of Domestic tickets.

Since the establishment of the company in 1993, Nitin International has established its presence internationally by providing manpower to companies in Saudi Arabia, U.A.E., Kuwait, Jordan, Oman, Bahrain, Sudan, Qatar & U.K. etc. all type of expert and experienced professionals like Engineers, Hospital Staff (Doctors, Staff Nurses, Technicians) , Chartered Accountants , IT Professional , Finance and Marketing Persons , Administration Staff , Teachers , Hotel & Garment Industry Staff , Petro Chemical workers , Industrial Workers , Building Construction & Transport Workers , Drivers , Heavy Earth Moving Machine

doc jobs

2009-09-25T08:50:00.000-07:00

Dear Doctors,

Greetings from Charishma

Jeddah National Group, Super Specialty Hospitals in Jeddah & Riyadh with The-State-Of-The-Art-Technology, chairman is visiting India for final interview for Doctors in all the disciplines.

We would like to invite you to attend the same, along with 2 sets of CV, Educational & Experience Certificates and 2 passport size photographs.

Date and Venue as follows:

Kozhikode (Calicut)

27th September 2009
Mr. Rasheed
Charishma Tours & Travels
Markas Complex, Mavoor Road,
Kozhikode - 4
Tel no: 049527220 65/9349705599

Cochin

28th September 2009
Mr. Naseer
Charishma Tours & Travels
Kalyan Chambers, 1st Floor
Chittoor Road, Ernakulam South
Cochin - 16
Tel no: 0484 2376402/ 9847095967

Alban Rose
Manager-Recruitment.
Mobile: 9220762553
Email: Charishmatt1@gmail.com

Consultants / Associate Consultants / Registrars / Fellows / Registrar MEDICA HOSPITAL

2009-09-12T05:00:00.000-07:00

Experience: 0 - 5 Years
Location:Kolkata
Compensation:As per industry norms,Salary would not be a constraint for the right candidate
Education:UG - MBBS - Medicine
PG - M.S/M.D - Cardiology, General Practitioner, Hepatology, Immunology, Microbiology, Neonatal, Nephrology, Obstretrics, Oncology, Orthopaedic, Pathology, Pediatrics, Psychiatry, Radiology, Rheumatology, Urology, Other
Industry Type:Medical/ Healthcare/Hospital
Functional Area:Healthcare, Medical, R&D

Job Description
1. Provide excellent standard of practice & care
2. Pay due regard to efficacy & the use of resources
3. Work within the limits of your agreed professional competence
4. Abide by the hospital rules, protocols and standard practices

Desired Candidate Profile
Exp in Clinical Pathology, Histopathology, Microbiology, Biochemistry, Blood Bank, Radiology, Emergency Medicine, Intensive Care.
Company Profile
Medica Synergie is a diversified but integrated healthcare company.
Medica is committed to bringing the best in medical care to Kolkata and towards this endeavour we are proud to announce the opening of our 500 bed superspeciality hospital at Kolkata
Contact Details

Company Name:
MEDICA HOSPITAL

Website:
http://www.medicasynergie.in

Executive Name:
Sudhanshu Roy

Address: Not Mentioned

Email Address:
hr@medicahospitals.in

Telephone:
9903200901

Reference ID:
MHPL/2009/08/112/Consultants

From Medscape Internal Medicine Seven Ways to Reduce Unnecessary Medical Costs -- Right Now! George D. Lundberg, MD

2009-09-07T06:19:00.000-07:00

I believe that there are still many ethical and professional American physicians and many intelligent American patients who are capable of, in an alliance of patients and physicians, doing "the right things." Their combined clout is being underestimated in the current debate on healthcare reform.

Efforts to control costs in the US healthcare system date from at least 1932. With few exceptions, they have failed. Healthcare reform, 2009 politics-style, is again in trouble over cost control. It will really be a shame if we once again fail to cover the uninsured because of hang-ups over costs.

Physician decisions drive most expenditures in the US healthcare system. In this system, costs will never be controlled until most physicians are no longer paid fees for specific services. The lure of economic incentives to provide care that is unnecessary, unproven, or even known to be ineffective encourages many physicians to make the lucrative choice. Hospitals and especially academic medical centers are also motivated to profit from many expensive procedures. Alternative payment forms used in integrated multispecialty delivery systems, such as those at Geisinger, Mayo, and Kaiser Permanente, are far more efficient and effective.

Fee-for-service incentives are a key reason why at least 30% of the $2.5 trillion expended annually for US healthcare is unnecessary. Eliminating that waste could save $750 billion annually, with no harm to patient outcomes.

Currently, several House and Senate bills include various proposals to lower costs. But they are tepid at best and in danger of being bought out by special interests at worst.

So what can we in the United States do right now to begin to cut healthcare costs?

An alliance of informed patients and physicians can widely apply recently learned comparative effectiveness science to big-ticket items, saving vast sums while improving quality of care.

Intensive medical therapy should be substituted for coronary artery bypass grafting (currently around 500,000 procedures annually) for many patients with established coronary artery disease, saving many billions of dollars annually.
The same for invasive angioplasty and stenting (currently around 1 million procedures per year), saving tens of billions of dollars annually.
Nonindicated prostate-specific antigen screening for prostate cancer should be stopped. Radical surgery as the usual treatment for most cases of prostate cancer should also cease because it causes more harm than good. Billions saved here.
Screening mammography should be stopped in women younger than 50 who have no clinical indication and sharply curtailed for those over 50, because it now seems to lead to at least as much harm as good. More billions saved.
Computed tomography and magnetic resonance imaging scans are impressive art forms and can be useful clinically. However, their use to guide therapeutic decisions is unnecessary much of the time. Such expensive diagnostic tests should not be paid for on a case-by-case basis but could be bundled together with other diagnostic tests by some capitated or packaged method that is use-neutral. More billions saved.
. We must stop paying huge sums to clinical oncologists and their institutions for administering chemotherapeutic false hope, along with real suffering from adverse effects, to patients with widespread metastatic cancer. More billions saved.
Death, which comes to us all, should be as dignified and free from pain and suffering as possible. We should stop paying physicians and institutions to prolong dying with false hope, bravado, and intensive therapy that only adds to their profit margin. Such behavior is almost unthinkable and yet is commonplace. More billions saved.
Why might many physicians, their patients, and their institutions suddenly now change these established behaviors? Patriotism, recognition of new science, stewardship, and the economic survival of the America we love. No legislation is necessary to effect these huge savings. Physicians, patients, and their institutions need only take a good, hard look in the mirror and then follow the medical science that most benefits patients and the public health at lowest cost. Academic medical centers should take the lead, rather than continuing to teach new doctors to "take the money and run."

Physicians can reaffirm their professionalism with sound ethical behavior and without undue concern for meeting revenue needs. The interests of the patients and the public must again supersede the self-interest of the learned professional.

George Lundberg, MD
Dr. Lundberg is president and board chair of The Lundberg Institute.

Neuromuscular Blocking Agents Dosing for Rapid Sequence Intubation

2009-09-07T06:17:00.000-07:00

What doses of neuromuscular blocking agents should physicians use in the emergency department for rapid sequence intubations?

Response from Ron M. Walls, MD, and Calvin A. Brown III, MD

Introduction

Succinylcholine (Sch) and rocuronium (ROC) are both recommended for rapid sequence induction intubation. The onset, extent, and duration of muscle paralysis are dose-dependent.

Pharmacodynamic studies suggest the effective dose (ED95) for succinylcholine is 0.3 mg/kg; adequate muscle relaxation may take 120 seconds.[1] Naguib and colleagues[2] randomized 180 patients to variable doses of Sch following fentanyl and propofol induction. They found that excellent intubation conditions at 50 seconds were obtained in 80% of patients with 1.5 mg/kg vs only 63% with 1.0 mg/kg Sch. The durations of action were 7.2 and 5.9 minutes, respectively.[2] Another study found that reducing Sch dose by 40% (from 1.0 mg/kg to 0.6 mg/kg) hastened muscle recovery by 90 seconds.[3] The superior intubation conditions achieved with the 1.5-mg/kg dose of Sch trumps any concern about this minimal increase in duration of action. Finally, muscle fasciculations and myalgias are less pronounced with 1.5 mg/kg dose than with lower doses.[4] Although some providers advocate for larger doses of Sch, such as 2 mg/kg, there is no pharmacologic or clinical rationale for this dosage increase in adults based on anecdotal experience. The best dose of Sch for emergency intubation is 1.5 mg/kg.

ROC is the preferred muscle relaxant when there are contraindications to Sch. A randomized study of patients using various doses of ROC identified 1 mg/kg as the dose necessary to achieve intubation in 60 seconds in 95% of patients.[5] Another randomized study of 349 patients also found that 0.6 mg/kg of ROC was inferior to 1 mg/kg.[6] In the emergency setting, achieving excellent intubation conditions reliably and early is paramount, arguing convincingly for the 1 mg/kg dose.

Two recent large meta-analyses containing only controlled trials showed that both clinically excellent and acceptable intubation conditions are more likely with succinylcholine compared to 0.6-0.8 mg/kg of ROC, independent of the induction agent. High-dose ROC (1.0-1.2 mg/kg) was statistically similar to Sch; however, the prolonged duration of action of ROC argues in favor of SCh as the drug of choice for emergency rapid sequence induction intubation, unless contraindications exist.[7,8]

While most drugs are dosed by total body weight (TBW) for normal-sized adults, morbidly obese patients are often dosed based on their "ideal" body weightor by "lean" body weight. Lean body weight adds 30% of the total weight increase (over ideal body weight) to account for increased intravascular and tissue volume. When dosed by TBW, succinylcholine has activity in obese adolescents equivalent to TBW dosing in nonobese controls.[9] A study of 45 morbidly obese patients undergoing bariatric surgery found that intubation conditions were superior in patients randomized to TBW vs ideal body weight dosing.[10]

There are few studies of ROC in morbidly obese patients, but most show a prolongation of the duration of action.[11,12] One study of patients with body mass index > 40 kg/m2 found that recovery to 25% of full muscle twitch tension was more than doubled (55 vs 22 minutes, P < .001) when TBW dosing was used vs ideal body weight. Time to onset of muscle relaxation, however, was not statistically different (77 vs 87 seconds).[13]

Summary

Sch remains the drug of choice for rapid sequence induction intubation and should be dosed at 1.5 mg/kg. ROC provides optimal intubation conditions at 1.0 mg/kg. In morbidly obese patients, Sch is dosed according to TBW while ROC is based on ideal body weight.

Calvin A. Brown III, MD
Instructor in Medicine, Harvard Medical School, Boston, Massachusetts; Director of Medical Student Education, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts

Ron M. Walls, MD
Professor of Medicine (Emergency Medicine), Harvard Medical School, Boston, Massachusetts; Chairman, Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts

THX TO MEDSCAPE

EMERGENCY MEDICINCE REGISTRARS FOR KUWAIT

2009-08-28T23:13:00.000-07:00

Experience: 3 - 7 Years
Location:Kuwait
Education:UG - MBBS - Medicine
PG - M.S/M.D - Other
Industry Type:Medical/ Healthcare/Hospital
Functional Area:Healthcare, Medical, R&D

Job Description
THE CANDIDATES FOR A REGISTRAR POSITION SHOULD HAVE THE MBBS FOLLOWED BY THE APPROPRIATE SPECIALTY.
Desired Candidate Profile
Dear Candidate,
We currently have an opening for REGISTRARS EMERGENCY MEDICINE for our reputed client in Kuwait (hospital for 202beds)
Qualification: MBBS/MASTERS/MD EQUIVALENT.
Experience: 3yrs after obtaining the Masters degrees.
Company Profile
AL-BADI Enterprises is a professional recruitment consultant located in Chennai India. For further details please visit our website www.albadi.co.in or call our recruitment team
Contact Details

Company Name:
Al-Badi Enterprises

Website:
http://www.albadi.co.in

Executive Name:
Rashmi

Email Address:
resumes@albadi.co.in,albadi.consultants@gmail.com

Telephone:
0444286631

A GOOD NEWS from dr suresh david CMC

2009-08-11T21:20:00.000-07:00

Ladies and Gentlemen

Today at 0100 hours, I inscribe a new sentence on the milestone of our specialty in India…. The Medical Council of India has recognized the Specialty of Emergency Medicine! This is the beginning of a new era… Yes, this day marks the end of a long walk through the tunnel of uncertainty. The pages, in the book of time, have indeed turned very slowly over the past 15 years. We have waited patiently, so close to the Finish Line, for so long, that we have forgotten the taste of sweet victory!

Some moments in our lives are distinct…this is one such….when we are summoned to the threshold of a new horizon… a new millennium for the fledgling fraternity of Emergency physicians in India; the fraternity, which will carve the image of our hopes and dreams….the fraternity of young lions and lionesses, who will salvage the deplorable state of emergency care in our country and raise it to the high ground which I have prayed for, since 1994.

On this day, let us remind ourselves, not to be torn by divisions of geography, language, pride or ego; not to be wooed or inflated by self-centric agencies that promise more than they can deliver. I pause on this gloomy note, since the shadow of rhetoric darkness descends periodically on our country; a shadow which threatens to splinter our forces and prevent us from being one. Let us lower our voices, strengthen our shoulders, raise our hands and stand together to garner the inner strength which prevails in all us, to address the common goal of advancing our specialty, through our thought, word and practice.

As trainers and trainees, let us learn not to force but to impart, not to transplant but to transform, not to teach but to inspire, the hundreds which are to follow us in the future. Let us balance technology against affordability, forced clinical practice against realism and resources.

Our task is to build a new Taj Mahal….because we can do it; because we have done it, in the past! We have endured the long night of waiting; as we glimpse at the emerging rays of dawn, come....join with me, as I dance with joy, this moment of awe and jubilation!

Suresh David

CMC Vellore, India.
Wednesday, August 12, 2009 1:07 AM

Fellowship in Emergency Medicine @MIMS under GWU

2009-08-03T03:14:00.000-07:00

2009 Batch
Students Joined

Dr.Jestin
Dr.Jiju Joseph
Dr.Vinil Badri
Dr.Sajid Majeed
Dr.Muralidhar [DA]

Dr.Yoga Murthy
Dr.Srikanthy
Dr.Sameer Rathi [D.Ortho]
Dr.Muneer
Dr.Sharmin
Dr.Kabeer

2007 Batch - Pass out

Dr.Fabith Moidheen
Dr.Shahul Hameed

Emergency Medical Officer

2009-07-23T07:30:00.000-07:00

Experience: 1 - 6 Years
Location:Gurgaon
Compensation:Best In the Industry
Education:UG - MBBS - Medicine
PG - Any PG Course - Any Specialization,Post Graduation Not Required
Industry Type:Medical/ Healthcare/Hospital
Functional Area:Healthcare, Medical, R&D
Posted Date:18 Jul

Job Description
To provide & coordinate emergency services, to ensure highest standards of patient care in emergency patient care wards including ambulatory services.
Desired Candidate Profile
To work out all patients presenting to the emergency room, to take detailed history and to do triage according to SOP. •To ensure all the investigations are sent & the reports are interpreted & inform the concerned consultants
Company Profile
Associate concern of Apollo Tyres. A 250 bedded superspeciality hospital in Gurgaon.
Contact Details

Company Name:
Artemis Medicare Services Pvt. Ltd

Website:
https://www.artemishospital.in

Executive Name:
HR Department

Address:
Artemis Medicare Services Pvt Ltd
Sector 51
GURGAON,Haryana,India 122001

Email Address:
annie@artemishealthsciences.com

Telephone:
91-124-67677881

Reference ID:
AHI_EMO_01

Keywords: CMO, Emergency Medical Officer

MOH INTERVIEW

2009-07-23T07:04:00.000-07:00

Dear Doctor,
MOH interview will start from 28.07.09 in Delhi and 3.08.09 in Bangalore. Kindly inform us where you would like to attend the interview in Delhi or Bangalore and date also.
For more information we are attaching herewith the delegation details.
You are most welcome to attend the interview through us.
Thanking you,
Reshma Ahmed
(Branch Manager)
09717935866
Ahmed Enterprises
148/A, IInd Floor, Deep Complex
Kilokari, Maharanibagh
New Delhi-110014
Ph: 011-26345999
011-26344555
Fax: 011-26345888

MOH Delegation

WANTED CHANGE CASUALTY IN TO EMD

2009-07-04T08:10:00.001-07:00

A leading HR Firm currently looking for Casualty Medical Officer (Head of Department) for one of the reputed hospital in Ludhiana.

Desired Skills:

The candidate must be working as a HOD in Emergency Department & having exposure in handling all kind of emergencies in a hospital.

If you have the same kind of experience & looking for change, can send your resume with following details:

Current CTC -
Expected CTC -
Experience -
Notice Period -
Ready to relocate Ludhiana -

Regards,
Poonam Sharma
Ph. no - 011-45630801
poonam@infotreeservice.com

WANTED ??ER DOC

2009-07-04T07:23:00.000-07:00

MAY BE THEY NEED AN EMERGENCY PHYSICIAN!!

Resident Medical Officer
Hospital/Trauma centre on National Highway-2 in Hodal, Haryana(78 Km from Delhi)

Experience:
1 - 6 Years
Location:
Hodal Haryana
Compensation:
Rupees 2,50,000 - 4,25,000
Salary is negotiable for deserving candidates
Education:
UG - MBBS - Medicine

PG - Post Graduation Not Required
Job Description
Hospital cum Trauma Centre in Hodal, Haryana(78 Kms from New Delhi)
MBBS with a minimum experience of 3 years in OPD/ICU/ICCU/CCU/Emergency.
Accommodation in campus for unmarried candidates.
Subsidized food for all employees
A two year old Hospital, Located just 78 Km from Delhi and 35 Km from faridabad on the Delhi-Mathura road.Equipped with all the latest speciality, super-speciality, emergency and paramedical services
Company Name:
Hospital/Trauma centre on National Highway-2 in Hodal, Haryana(78 Km from Delhi)

Website:
Not Mentioned

Executive Name:
Mr. Sachin

Address:
Not Mentioned

Email Address:
cv@topleaf.net

Telephone:
9873395511

Reference ID:
SOIN-RMO

FELLOWSHIP DIRECTOR's WELCOME MESSAGE FOR THE 2009 BATCH

2009-06-23T19:44:00.000-07:00

Greetings from Washington.

It is an exciting time in the Emergency Medicine at MIMS. The first graduating class is preparing for final exams and graduation, and a new class has committed to the pursuit of Emergency Medicine as a career and committed to the Post Graduate Fellowship Program in Emergency Medicine.

I am pleased to welcome the new batch of trainees to the exciting field of Emergency Medicine.

I commend your dedication to this still new and very important specialty of medicine, and your commitment to the development of Emergency Medicine in India.

Your patients and your community will truly benefit from your hard work and dedication.

Best of luck to the graduating class on their exams and beyond, and welcome to the new batch of fellows in Emergency Medicine.

All the best,

Kate Douglas, MD MPH

Fellowship Director
kdouglas@mfa.gwu.edu

24 MODULES LIST FOR FEM

2009-06-19T06:05:00.000-07:00

Module List height="500" width="100%" > value="http://d.scribd.com/ScribdViewer.swf?document_id=16582219&access_key=key-y6wep8o63fkgrtdmenx&page=1&version=1&viewMode=">

WELCOME FRESHERS!!

2009-06-18T03:16:00.000-07:00

WELCOME to our new batch of fellows.

wishing the third batch the best of luck and all success in their endeavours.

1 Dr Murali

2 Dr Justin

3 Dr Vinil

4 Dr Jiju

5 Dr Nagveni

6 Dr Sajid

plz view the prev-Director's and our CHIEFS message respectively in the following links

http://ifemgwumims.blogspot.com/2007/07/directors-message.html

http://ifemgwumims.blogspot.com/2007/08/chiefs-message.html

EM CME 09 BROCHURE

2009-03-01T08:04:00.002-08:00

EM CME 09 BROCHURE pg 1

Publish at Scribd or explore others: Education Brochures & Catalogs emergency medicine c

EM CME 09 BROCHURE pg 2

Publish at Scribd or explore others: Education Brochures & Catalogs emergency medicine c

REGISTRATION FORM

2009-03-01T08:04:00.001-08:00

Registration Form

Publish at Scribd or explore others: Academic Work emergency medicine

INDUS-EM SUMMIT 2008

2008-09-29T09:23:00.000-07:00

http://www.indusem.com/conference_site/html/index.html

DETAILS A
http://www.indusem.com/conference_site/html/academic_plan.pdf

JOURNAL OF EMERGENCIES TRAUMA AND SHOCK

2008-09-29T09:19:00.000-07:00

http://www.onlinejets.org/
Journal of Emergencies Trauma and Shock (JETS) is the official journal of the INDO-US Emergency and Trauma Collaborative.
The journal will be published semiannually (June and December) in 2008 and quarterly from 2009 (January, April, July, October).
Global Emergency Medical Sciences
INDUS-EM & Trauma Collaborative
University of South Florida-
Emergency Medicine
One Davis Blvd, Suite 504,
Davis IslandTampa,
Florida,
33606 USA

STRESS OF MEDICAL TRAINING

2008-03-14T01:37:00.000-07:00

http://www.medscape.com/viewarticle/570420?src=mp
Question
I feel like my residents and attendings always expect more of me, which causes considerable stress. What can I do to reduce this constant feeling of pressure?

Response from Geoffrey Talmon, MDSurgical Pathology Fellow, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota

As a third-year medical student, I was assigned to an obstetrics rotation off campus with a group of private physicians. They were notorious for pushing their medical students hard, and consequently I was dreading those 6 weeks. During the first half of the rotation, we were absolutely swamped. Every delivery room was always filled, and we always seemed to have a very long inpatient census to round on each morning. Added to this, it seemed as though I did nothing right. My attending would tear my notes to shreds as he critiqued them, I never seemed to answer any question correctly, and in surgery I was apparently incapable of holding a retractor. This was a level of pressure that I had never experienced before. I certainly did not talk about it; weren't medical students supposed to be able to deal with all of this with a smile on their face?
One night, I was in the doctor's lounge while on call, and my attending asked me how I was doing. I must have been really tired because I actually told him about all of my anxiety. He smiled and admitted that he tended to ride medical students hard, but he said that his expectations were simple: See your patients in the morning and write a note, participate in rounds, and show that you were reading about your patients. All of the other criticisms were in an attempt to make me improve and be more efficient. He said that I was at least meeting if not exceeding all of his expectations. After hearing this, the pressure that I felt while on service was reduced incredibly, and I actually enjoyed the rotation.
Handling pressure from superiors is a constant in life. From school to business to sports, it is something that everyone must find a way to deal with in order to succeed. It is one of the skills that employers often use to determine who is promoted and who cannot handle their current position. As such, a number of books, presentations, and symposia have been developed to provide advice on handling pressure.
Medicine is no exception. On top of the stress that comes with making decisions that affect patients' lives, perceived demands from residents and attendings create more anxiety. The hierarchy of academic medicine makes coping with these stressors even more complex. Attending physicians' diverse backgrounds engender numerous styles of teaching and interaction with subordinates, as well as differing levels of patience with student doctors. As a result, determining what is wanted of a trainee can seem like aiming at a moving target.
On top of all this, medical students often have high self-expectations and a desire to please. This can make handling pressure even more difficult. When I discussed high-pressure rotations with my friends during medical school, many of them would say things such as, "Well, at least it only lasts for a month." This thought offered little solace as I was often very concerned with my evaluation or the potential for a letter of recommendation. For those like me, how does one deal with pressure from more senior physicians?
To start, it is important to recognize that "pressure" does not equal abuse. The days are over when medical students had to put up with verbal abuse from supervising physicians. Even if an attending is glaringly upset with your performance, there is no excuse for name-calling, swearing, or insults. In such instances, nearly every medical school has mechanisms for reporting unacceptable behavior, often starting with the rotation director.
It is also important to determine the source of your pressure; is it coming from your superiors or from inside yourself? Almost all medical students are driven to overachieve, so we often set unrealistic standards. We feel that we need to answer every question correctly, present every patient perfectly, write the best clinic notes, etc. Whenever we fail at one of these self-imposed goals, we experience internal anxiety. Then, the more that is asked of us, the more pressure we feel. In hindsight, I realize that most of the time when I felt "under pressure" while on service, it was of my own making. Two nonthreatening ways to determine the source of your pressure is to ask other students who were on the rotation before you what the attending expected of them, or talk to your residents about your performance.
Similarly, you may be able to reduce the pressure from senior doctors if you know precisely what they want from you. Thinking back, some of the best attendings and experiences I had on service came when I was told at the very beginning of my rotation what my responsibilities were. I did not have to "guess" what I was supposed to be doing, which often removed a large amount of stress from my day-to-day activities. It is almost never incorrect to ask your supervisors this question, although it is advisable to have such discussions in private and at a less hectic time than during the middle of rounds or a surgery.
So, what should you do when there is true pressure from your supervisors to perform, either due to the volume of work or high expectations? Unfortunately, these situations are occasionally unavoidable, and they often occur as a student gains more responsibility (eg, a new fourth-year medical student or a new first-year resident). In most cases, the goal is to make you more efficient -- shorter notes, more focused histories and physical exams, and so on. Again, the key to handling these situations is talking with your senior physicians. Ask them for their assessment of your performance and for hints and/or advice on how to improve.
The overriding theme in all of these tactics is communication. When you, as the student doctor, feel that the weight of demands placed upon you by senior physicians is causing excessive anxiety, talk to them about it. Ask them what is expected of you, whether you are meeting those expectations, and what you could do to improve. Because the goal of academic medicine is to turn you into a better physician, such questions are not inappropriate, and they can help reduce the amount of stress and pressure that you are feeling.

2007-11-06T04:57:00.000-08:00

One day I decided to quit...
I quit my job, my relationship, my friends, my spirituality... (not IFEM)
I wanted to quit my life.
I went to the woods to have one last talk with God. "God", I asked, "Can you give me one good reason not to quit?" His answer surprised me... Look around", He said. "Do you see the fern and the bamboo?" "Yes", I replied. "When I planted the fern and the bamboo seeds, I took very good care of them.. I gave them light. I gave them water. The fern quickly grew from the earth. Its brilliant green covered the floor. Yet nothing came from the bamboo seed. But I did not quit on the bamboo. In the second year the Fern grew more vibrant and plentiful. And again, nothing came from the bamboo seed. But I did not quit on the bamboo. He said. "In year three there was still nothing from the bamboo seed. But I would not quit. In year four, again, there was nothing from the bamboo seed. I would not quit." He said. "Then in the fifth year a tiny sprout emerged from the earth. Compared to the fern it was seemingly small and insignificant...But just 6 months later the bamboo rose to over 100 feet tall. It had spent the five years growing roots. Those roots made it strong and gave it what it needed to survive. I would not give any of my creations a challenge it could not handle." He asked me. "Did you know, my child, that all this time you have been struggling, you have actually been growing roots". "I would not quit on the bamboo. I will never quit on you." "Don"t compare yourself to others." He said. "The bamboo had a different Purpose than the fern. Yet they both make the forest beautiful." "Your time will come", God said to me. "You will rise high" "How high should I rise?" I asked. "How high will the bamboo rise?" He asked in return. "As high as it can?" I questioned. "Yes." He said, "Give me glory by rising as high as you can." I left the forest and brought back this story.I hope these words can help you see that God will never give up on you. Never, Never, Never Give up.

Indian doctors may soon be able to practice in Britain

2007-10-30T02:00:00.000-07:00

NEW DELHI: Indian doctors may soon be able to practice in Britain without having to go through a series of qualifying exams, with a consensus on the issue reached at a meeting of the Health Care Working Group of the UK-India Joint Economic Trade Committee (JETCO) on June 6.
The working group had proposed that medical degrees from reputed institutions be recognised by both the countries on a case by case basis as it would cut out years of qualifying examinations, besides ease rules governing issue of visa to the recognised degree-holders.report continued below
Once accepted by the both governments, even qualified doctors from UK would be able to practise in India.
The proposal would now be put before JETCO in the first week of July prior to its presentation to the two governments.
JETCO is co-chaired by India's Commerce and Industry Minister Kamal Nath and British Trade Minister Alistair Darling.
Significantly, Health Care Working Group is co-chaired by UK government official David Hawkins and Fortis Managing Director Shivinder Mohan Singh, who also heads FICCI's health care committee. JETCO's Health Care Working Group is being co-ordinated from India by FICCI.
"JETCO's own working group has reached a consensus and the ball has started rolling," said FICCI Secretary General Amit Mitra.
At present, immigrant doctors are required to take professional and linguistic assessment board test and nurses are required to clear qualifying exams to register with the Nurses and Midwife Council in the UK.
Both Medical Council of India (MCI) and The British General Medical Council (GMC) stopped recognising each other's medical degrees over 3O years back.
Mitra said if the governments agree on the proposal, both the nations would benefit. India in the coming 2-3 years would need more experts and medical specialists since the demand in corporate hospitals is going up.
It will also help Britain to address the problem of human resource crunch in this area.
"India will gain from knowledge-sharing and medical tourism will also get a boost from this initiative," he added.
http://www.dnaindia.com/report.asp?newsid=1103087 http://www.rediff.com/money/2007/jun/13uk.htm

Medical Journal Review

2007-10-26T11:31:00.000-07:00

Medical Journal Review is an attempt to expose the medical students to the world of Medical Journals.
It provides the latest information , from the latest and most reputed medical journals around the world in a simple worded question answer format.
It is invaluable for Undergraduates from IInd MBBS onwards who are preparing for their examination and also for those preparing for All India Entrance examination and other competitive exams like AIIMS, USMLE, PLAB etc.

http://medicaljournalreview.blogspot.com

AMERICAN OBSERVERSHIP.........THINGS U MUST KNOW

2007-10-26T11:15:00.000-07:00

HI FELLOWS!

though i am away on a mission??......i miss u all and
i want and request all to jus go thro the site
i hope it will be very useful for us to plan and understand more about our observership in RRIEM

let me know if this piece of info was useful................i will be happy to know

http://www.usmletomd.com/usce/

Elevated Troponin Levels May Be a Marker for Increased Mortality in ACS

2007-10-22T22:23:00.000-07:00

October 10, 2007 (Seattle) —
Patients with acute coronary syndrome presenting to the emergency department with transient elevation in the ST segment of their electrocardiogram (ECG) who also have elevated troponin levels may be at increased risk for death. The finding suggests that such patients should be treated more aggressively.
Researchers presented the study here at the American College of Emergency Physicians (ACEP) 38th Annual Scientific Assembly.
ECG changes can suggest either acute injury to the heart (elevated ST segment) or ischemia (normal ST segment). However, some patients present with transient ST-segment elevation (tSTE), and there is no consensus for how aggressively these patients should be treated.
Using data from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA guidelines (CRUSADE) initiative, researchers examined the troponin levels of patients with tSTE in hopes of further stratifying this subgroup of patients.
The CRUSADE initiative included 205,000 patients at more than 500 US sites between 2001 and 2007. Patients had ECG abnormalities suggesting acute coronary syndrome or abnormal serum markers indicating myocardial necrosis.
Of 189,000 patients enrolled at the time of this analysis, the researchers found that 11,979 patients had tSTE and had undergone troponin testing. Several factors were associated with tSTE (with "transient" defined as lasting < 10 minutes), including male sex (P < .001) and family history of coronary artery disease (P = .012).
Factors associated with reduced likelihood of tSTE included
renal insufficiency, hypertension, and history of congestive heart failure (P < .001 for each).
Of the 11,979 patients with tSTE,
8272 (69%) had elevated troponin levels;
3707 patients (31%) had negative troponin markers.
The researchers compared patients in the 2 categories and found that
patients with tSTE and elevated troponin levels had a 41% increased risk for death during their hospital stay (4.6% vs 2.2%; adjusted odds ratio, 1.41; 95% confidence interval, 1.04 - 1.91;P = .028) compared with patients with tSTE and normal troponin levels.

"Our conclusion was that if a patient with tSTE has abnormal troponin levels, they are in a higher risk group and should be evaluated for more aggressive therapy," said Lee Garvey, MD, medical director of the chest pain evaluation center at the Carolinas Medical Center, Charlotte, North Carolina.
"[The study] identifies a group of patients with a 40% increased risk for acute mortality. Once again, it's a demonstration that troponin is the most important biomarker for acute coronary syndrome," said W. Frank Peacock, MD, director of research for the Cleveland Clinic, Ohio, who attended the conference.
The study was internally funded. Dr. Garvey has disclosed no relevant financial relationships. American College of Emergency Physicians 38th Annual Scientific Assembly: Abstract 22. Presented October 8, 2007.
Pearls for Practice
Factors that reduce likelihood of tSTE in patients with acute coronary syndrome include renal insufficiency, hypertension, and history of congestive heart failure, while male sex and family history of coronary artery disease increase this risk.
The presence of abnormal troponin levels in patients with acute coronary syndrome and tSTE is associated with an increased risk for in-hospital mortality, with an odds ratio of 1.41.

REF: http://www.medscape.com/viewarticle/564047?src=mp

Computed Tomography Improves Detection of Cervical Spine Injuries

2007-10-22T22:12:00.000-07:00

October 11, 2007 (Seattle) — In a study of emergency department patients with blunt trauma, cervical computed tomography (CCT) significantly outperformed cervical spine radiographs (CSRs) at detecting spinal injury.
The study was presented here at the American College of Emergency Physicians 38th Annual Scientific Assembly.
About 10,000 Americans have cervical spine injuries each year, and delayed diagnosis has important clinical and economical costs. CSRs have a reported sensitivity ranging from 35% to 89%; the study authors conducted a study to determine whether CCT has greater sensitivity in the detection of these injuries than CSR.
They carried out a prospective study of patients who presented with blunt trauma during the course of 23 months at an urban public hospital's trauma center. Patients received both a 3-view CSR and CCT, each read independently by attending radiologists who were blinded to other tests.
Of 1580 study patients, 60 (4%) had injuries that were detected by CSR or CCT. CSR detected the injury in 21 of these patients (35% sensitivity), whereas CCT detected injuries in 58 patients (97% sensitivity). Of the 60 patients, 45 had injuries that were considered clinically significant (defined as requiring an operating room procedure, halo application, or hard collar). CCT identified all of these cases (100% sensitivity), whereas CSR detected just 15 injuries (33% sensitivity). In 2 cases, injury was identified by CSR and not CCT, but neither injury was clinically significant.
The study had some limitations, including the fact that it was conducted at a single institution and that 78 patients were dropped because of protocol violations. There was also no structured follow-up.
There are also some safety considerations regarding CCT. "We don't know the effects of radiating children or young adults," said Matt Beecroft, MD, from Cook County Hospital, Chicago, Illinois. "The thyroid is right there [where images are being taken]. Radiation levels are 14 times higher in CT than x-ray. I think that question will be answered as time goes on." He called for further research to define a subset of patients who would not require CCT, as well as cost analyses and studies on the effects of CT radiation.
"We thought we had a good decision-making rule" for screening for cervical injuries, said Charles Bennett Cairns, MD, director of research in the Division of Emergency Medicine at Duke University School of Medicine,Durham, North Carolina, who attended the presentation. "It shows that we need to better understand the limitations of the decision-making rules and how they apply to different institutions and different populations."
American College of Emergency Physicians 38th Annual Scientific Assembly: Abstract 2. Presented October 8, 2007.
The study was internally funded. The authors have disclosed no relevant financial relationships.
Pearls for Practice
In patients who had injuries that were detected by CSR or CCT, CCT was more sensitive than CSR in detection of these injuries. For patients with clinically significant injuries, defined as requiring an operating room procedure, halo application, or hard collar, sensitivity was higher with CCT. In 2 cases, injury was identified by CSR and not by CCT, but neither injury was clinically significant.
The safety of CCT in children or young adults is unknown. There is concern regarding inclusion of the thyroid in the field of radiation exposure. The investigators recommend further research regarding the effects of CT radiation

REF:
http://www.medscape.com/viewarticle/564129?src=mp

CARDIOGENIC PATHOPHYSIOLOGY

2007-09-28T23:59:00.000-07:00

http://docs.google.com/Present?docid=dgctv9nk_68c7qt2v&fs=true

MICROCIRCULATION

2007-09-28T23:50:00.000-07:00

http://docs.google.com/Present?docid=dgctv9nk_23d5gnpz&fs=true

ONLINE BOOKS

2007-09-26T02:00:00.001-07:00

http://www.unifesp.br/universidade/english/dis/libraries/books.htm

ONLINE RESOURCES

2007-09-26T01:50:00.001-07:00

MedicalStudent.com is a digital library of authoritative medical information for all students of medicine

http://www.medicalstudent.com/

LEARN ECG ONLINE

2007-09-26T01:42:00.000-07:00

THE ALAN E. LINDSAY ECG LEARNING CENTER Frank G. Yanowitz, M.DProfessor of MedicineUniversity of Utah School of MedicineMedical Director, ECG DepartmentLDS HospitalSalt Lake City, Utah
This tutorial is dedicated to the memory of Dr. Alan E. Lindsay, master teacher of electrocardiography, friend, mentor, and colleague. Many of the excellent ECG tracings illustrated in this learning program are from Dr. Lindsay's personal collection of ECG treasures. For many years these ECG's have been used in the training of medical students, nurses, housestaff physicians, cardiology fellows, and practicing physicians in Salt Lake City, Utah as well as at many regional and national medical meetings. It is an honor to be able to provide this tutorial on the World Wide Web in recognition of Dr. Lindsay's great love for teaching and for electrocardiography.
This interactive ECG tutorial represents an introduction to clinical electrocardiography. ECG terminology and diagnostic criteria often vary from book to book and from one teacher to another. In this tutorial an attempt has been made to conform to standardized terminology and criteria, although new diagnostic concepts derived from the recent ECG literature have been included in some of the sections. Finally, it is important to recognize that the mastery of ECG interpretation, one of the most useful clinical tools in medicine, can only occur if one acquires considerable experience in reading ECG's and correlating the specific ECG findings with the pathophysiology and clinical status of the patient.
The tutorial is organized in sections based on a recommended "Method" of ECG interpretation. Each section provides some didactic teaching points, often linked to illustrations, and an interactive quiz. Beginning students should first go through the sections in the order in which they are presented. Others may chose to explore topics of interest in any order they wish. The ECG's range from the sublime to the ridiculous, from simplicity to complexity, and from boring to fascinating. It is hoped that students will be left with some of the love of electrocardiography shared by Dr. Lindsay.

http://library.med.utah.edu/kw/ecg/index.html

ACUTE PERICARDITIS

2007-09-25T01:53:00.000-07:00

http://docs.google.com/Present?docid=dgctv9nk_1c3tcrm&fs=true

EM TEAM

2007-09-20T09:15:00.000-07:00

Right to Emergency Care:

2007-09-20T09:12:00.000-07:00

READ the new rule implemented by Supreme Court and be aware

Right to Emergency Care
The Supreme Court has ruled that all injured persons especially in the case of road traffic accidents, assaults, etc., when brought to a hospital / medical centre, have to be offered first aid, stabilized and shifted to a higher centre / government centre if required.
It is only after this that the hospital can demand payment or complete police formalities.
In case you are a bystander and wish to help someone in an accident, please go ahead and do so.
Your responsibility ends as soon as you leave the person at the hospital. The hospital bears the responsibility of informing the police, first aid, etc.

Please do inform your family and friends about these basic rights so that we all know what to expect and what to do in the hour of need.

SO FOLKS â€¦..Here after don't hesitate to help the victims of an accident incase if u encounterâ€¦raise Ur helping hands â€¦..

Apollo, Deccan Aviation offer air ambulance service

2007-09-13T22:22:00.000-07:00

Apollo Hospitals Enterprises and Deccan Aviation, partners in a new heli-ambulance service plan,
hope to rope in medical insurance companies to drive up the market.
A large number of emergency cases need air-lifting for timely medical attention and helicopter service being expensive, it is up to health insurance companies to make it affordable by offering it in their policies, said
Ms Sangita Reddy, Executive Director, Operations, Apollo Hospitals Enterprises, and
Capt. G.R. Gopinath, Executive Chairman, Deccan Aviation, here on Wednesday.
Talks are on with 3-4 insurance providers and the concept could be a reality soon pending approval of the insurance regulator, they said at the demonstration of the service.

The Apollo group has made 400 emergency air-lifts in the past two-and-a-half years and each trip can cost the patient Rs 1-2 lakh depending on the distance to the hospital, or around Rs 75,000 an hour, Ms Reddy said.

With a formal policy, the cost could be brought down. Corporates tie-up Another mode would be to allow corporates to tie up with insurance companies for the service.
According to Ms Reddy, up to 10 cases a day across the country could be requiring emergency air-lifts. “The time has come for insurance companies to step forth and provide medical insurance which covers air ambulance services, on the lines of Western countries,”
Capt. Gopinath said. “An alarming number of patients or accident victims succumb without medical help in the first or golden hour [of a medical crisis]. There is an urgent need to plug this gap by providing immediate medical assistance which also includes air-lifting.”
Third-party administrator MediAssist India P Ltd is sharing the cost with Apollo Hospitals, said Mr B. Madhavan, CEO, MediAssist.Deccan Aviation, the 10-year-old chartered helicopter operator, has a fleet of 10 helicopters and two small planes stationed at Bangalore, Mumbai, Delhi, Hyderabad, Ranchi, Surat and Katra in Jammu & Kashmir.
Apollo will offer the services of Deccan Aviation’s helicopters at its centres in Bangalore, Delhi, Bhubaneswar and Kolkata, where it has either roof helipads or landing facilities.
One of Deccan’s helicopters took off from Jakkur, 30 km away, and landed within 15 minutes at the 250-bed New Apollo Hospitals in south Bangalore. The service, part of Apollo Emergency Specialists 1066, will be available within half an hour of call, along with onboard life support systems, trained personnel and care during flight, said Dr Umapathy Panyala, COO, New Apollo. Creating the landing facility would be another onus on hospitals, he said.

Overseas medical degrees to be recognised

2007-09-01T23:36:00.000-07:00

THE HINDU AUG 27 2007
Special Correspondent
CHENNAI:

India will recognise postgraduate medical degrees offered by universities in the United States, the United Kingdom, Australia, Canada, New Zealand and Singapore soon.
“In three months’ time, doctors from these English-speaking countries will be recognised here, enabling them to work in Indian hospitals. At the moment, only unilateral recognition has been accorded. We are talking with these countries to urge them to grant bilateral recognition to enable Indian medical degrees to be recognised abroad,” Union Minister for Health and Family Welfare Anbumani Ramadoss told reporters on Sunday.
He was inaugurating the Dr. A. Ramachandran’s Diabetes Hospitals and India Diabetes Research Foundation.
India was moving from being the epicentre of the Big Three diseases — HIV/AIDS, malaria and tuberculosis — to the Big Five diseases — diabetes, cardiovascular diseases, mental health disorders, stroke and cancer. Educational policies had to be modified accordingly to cope with this and the Union Health Ministry was in talks with the Human Resources Development Ministry to make physical education a compulsory subject in school curriculum. Talks were also on with the Urban Development Ministry to make it mandatory for all public parks to have tracks for walking, to encourage physical exercise as a means to cope with diabetes. The prevalence of HIV/AIDS had come down in Tamil Nadu over the last three years, with Andhra Pradesh topping the list.
The Ministry had also written to all Chief Ministers and Vice-Chancellors of universities to ban the sale of junk food on campuses.

http://www.hindu.com/2007/08/27/stories/2007082755821200.htm

http://indian-medicos.blogspot.com/2007/08/overseas-medical-degrees-to-be.html

ANAPHYLACTIC SHOCK

2007-08-22T12:01:00.000-07:00

CHIEF'S MESSAGE

2007-08-22T11:22:00.000-07:00

Dear Fellows,
Emergency Medicine in India still in infantile stage.
MIMS in association with GWU Washington DC is trying to develop this new and the most life saving speciality at this part of country.
Fortunately I have got 12 excellent , enthusiastic ,committed and dedicated doctors as fellows at MIMS.
I can see a bright future ..
I can see the silver line ..
I can see the 12 fellows fling at the heights and truly
you are here in my heart, my blood and my breath and ...
and in my dreams.
I am sure ..this is a great beginning .
We have to move together to build a new medical culture in this field.
Emergency Medicine and its approaches are some thing like a commando operation.
Our time in ER is limited while managing unstable patients.
Our assessment and decisions are so vital as far as patients life is concerned.
We are very often handling life and death scenarios.
Our stability ,commitment, responsibility , body language ...
everything is important.
No patient will come to your ER in the midnight ,if they can tolerate their symptoms for another few hours.
Remember
that is what emergency medicine is!
All the bests

Dr.VENUGOPALAN.P.P,
M.B;B.S,DA,DNB,MNAMS,
Chief,Emergency Medicine,
Coordinator, MIMS Academy,
MIMS-CALICUT ,
KERALA,
INDIA.
Mobile - 91 9847054747
website-www.mimsindia.com
http://groups.google.co.in/group/emergencymedicinemims
drvenugopalpp@gmail.com,
venugopal@mimsindia.com.
emergencymedicineindia@yahoo.co.in

DR ELEZABETH

2007-08-13T06:39:00.000-07:00

Dr Elezabeth is at MIMS now for a week to train fellows

DIRECTORS MESSAGE

2007-07-16T02:51:00.000-07:00

Dear IFEM Fellows,

Medicine is a very old field with physicians practicing from times of the Vedas and the Greek dynasties. However, science and technology have brought this ancient art to a very modern sphere.
I would like to thank you for choosing to embark on this important endeavor to train in Emergency Medicine at MIMS under the guidance of GWU and IIEMS.
Emergency Medicine is relatively new field, and to bring this unique specialty to India will require your intellectual talents and your devoted enthusiasm.
Patients suffer daily from acute medical and surgical conditions, and I am confident that
your commitment will help save the lives of the patients who present to the Emergency Department at MIMS.
I am also confident that you will set the standard of excellence for this field for future Emergency Physicians in India.

With warm regards,
Bobby

Girish Bobby Kapur, MD, MPH