The public health system in Guyana has only one tertiary center, which is located in the capital city, Georgetown. This single referral center, the Georgetown Public Hospital Corporation (GPHC), is supported by several regional hospitals and health centers in varying levels of development across the country. Health care in Guyana has been gradually developing, and there are currently five local centers for undergraduate medical training for both Guyanese and foreign students.
Postgraduate education and training was nonexistent in Guyana prior to 2008. After multiple efforts of collaboration between the University of Guyana, GPHC, and Vanderbilt University Medical Center (VUMC), a Masters in Emergency Medicine program was launched in September 2010. This was formulated from a three-year curriculum taken from the Vanderbilt model. At that time, VUMC sent Dr. Nicolas Forget, the inaugural program director, to Guyana to oversee the course.
Since 2013, the Masters in Emergency Medicine program has celebrated 6 classes of 14 graduates. The graduates have gone on to serve as the head of department at other hospitals, as well as filling roles at GPHC such as head of the Accident and Emergency department, trauma coordinator, nursing care coordinator, senior registrar and floor supervisor, emergency ultrasound expert, medical student coordinator, and ED administrator. They are also involved in teaching the staff and current residents at GPHC. Dr. Zelda Luke-Blyden, who graduated in 2015, took over as program director from Dr. Forget in 2018.
The sixth class of graduates (November 2018) was the first batch to have access to the Rosh Review question bank. One of the first-year residents reached out to the Rosh team requesting a free subscription for the program. His request was granted, and the GPHC program gained access to a 1,200-question subscription. The two recent graduates used that subscription, which largely contributed to their preparation for the Master’s Exam in September 2018. They both reported practicing the questions multiple times, and both had excellent scores at the Boards Exams.
The program currently has 10 residents, 2 of whom are preparing for their final exams in September 2019.
Voices of the current residents:
“At GPHC currently we have three senior residents (third years), two males and a lonesome female, who battled and empowered their way over the past two and a half years to get to where we are presently. We can all attest to barely knowing anything about emergency medicine in the beginning, but being driven by a hunger for both knowledge as well as adrenaline is what kept us going over the years. Even though our emergency medicine program is fairly new (nine years old), it has grown significantly, and anyone, regardless of year, can honestly say that it’s heading in the right direction under astute leadership along with collaboration from the University of Vanderbilt. We may not have everything at our disposal (low resource setting), but we most certainly try to make the best out of what we do have and take solace in the fact that we are moving forward and paving the way for others (other local programs in the country) to follow.
Life as a third-year emergency medicine resident at GPHC is extremely challenging and even overwhelming as we’re sure it is in any residency in any other part of the world. There is additional pressure that was never a part of us during our first two years of residency as we endeavored to learn everything that we could have at the time. Notwithstanding, we fully understand and embrace the level of responsibility given to us as senior residents and hopefully senior registrars in the near future. This program hasn’t only taught us how to become good emergency physicians, but also to become great leaders in our country despite the fact that it is resource limited.
A little over one year ago, Rosh Review was incorporated into our curriculum and has become quite popular amongst us, as many of us would reference Rosh in our medical debates as well as in exams, and it even influences some decision making while on shift. Rosh has become our go-to tool for exam preparation as it covers each and every aspect of emergency medicine and encompasses high-yield questions with concise and precise explanations. This app is definitely an asset to all emergency medicine residents and allows us to continue the battle in improving emergency care in our dear Guyana. We would like to extend our sincerest gratitude for the privilege of using Rosh Review and want to thank you in anticipation for your continuous support as our only regret in residency thus far is not having access to Rosh in our first two years of studies.”
“I joined the emergency medicine residency program at Georgetown Public Hospital Corporation in May 2017. Looking back, I can now say that the decision to join emergency medicine has been challenging but fulfilling. There is no other specialty that I can see myself being passionate about. From the hectic shifts of the multiple STEMIs to the stab wound with a pneumothorax, this is what I live for. Having access to Rosh Review for the past year has greatly improved my knowledge and has prepared me for the In-Service Exams. Never before has this been available to our residency program, hence, having access to this has helped us as residents to have an understanding and feel of what the Board Certified Exams are like. This gives us an opportunity to be tested just as our US colleagues while at the same time assessing the quality of our local program. Your commitment to global EM knowledge and enhancement is what drives us here in Guyana to be the best. We look forward to making this partnership a success not only for ourselves but ultimately the patients who deserve the best possible EM physician.”