WONCA Special Interest Group: Emergency Medicine

Emergency Medicine

WONCA Special Interest Group on emergency Medicine was approved by the WONCA Council in October 2016. Membership is open to all interested family doctors, as well as we open our doors to all health workers whose activity is developed in the field of emergency medicine, medicine in hostile environments and remote areas.

Background

One of the reasons for the obvious difficulties in recruiting and retaining GPs in ERs, rural and remote areas could be the challenge of everyday emergencies and, quite often, the uncertainty of whether we could manage them. This is especially crucial for all the urban doctors, GPs working in modern small-town or rural communities, who work in relative professional isolation with a common lack of collegial support and an increasing proportion of elderly, frail and challenged population groups.

Family medicine encompasses the care of persons and families of all ages, all sexes, every organ system, and every disease entity from its acute presentation to its chronic management.

Many family doctors practice in an emergency medicine/urgent care setting. The American Academy of Family Physicians has a position paper in support of family doctors delivering emergency room care. Nearly 25% of members of the AAFP describe urgent care or emergency medicine as part of their scope of practice. In Canada, there are over 3000 family doctors who hold a certificate of special competency in emergency medicine. In addition, there are several thousands more family doctors who provide emergency medicine as part of a comprehensive continuing practice. The vast majority of in-hospital and out-of-hospital emergency professionals in Spain are currently Family Physicians (sometimes up to 80% of the workforce) together with other specialties (mainly Internal and Intensive Medicine). Many countries do not have a specialty in emergencies, often presenting adequate levels of quality (France, Germany ...) and others, such as Canada, New Zealand, and Australia, successfully combine the operation of professionals from both specialties in care of urgent and emerging pathologies which occur both at the first level of care (rural areas, Primary Care consultation, Continuous Care consultations) and at the hospital level. In many low middle income countries (LMIC), like Nepal or India it is primarily the general practitioners who provide acute medical care to patients in the rural community health centers and larger regional centers.

The latest version of the Teaching Program for the Specialty of Family and Community Medicine in many countries reviewed the entire content of the training period, given the "pluripotential training demand" in relation to Emergencies, it set the guidelines for training the future specialist so that he can work in emergency services, expanding teaching environments and including emergency units in which the activity of the future specialist can develop. Due to the high level of demand for urgent and emergent pathology care at all the levels of care (hospital level, remote and rural areas, Primary Care and Continuous Care consultations) and scarce resources of emergency specialists in the world, the Family Medicine's goal is focused today on ensuring that the scope of family medicine practice remains capable of serving all patient populations in diverse settings, including urgent / emergency care in a competent and compassionate manner.

Guaranteeing the quality of this preparation and hence the visibility, recognition and respect for our knowledge and work worldwide is our goal.

Join our SIG

Convenor / Chair

Dr Nisanth Menon Nedungalaparambil (India)

Dr. Nisanth Menon Nedungalaparambil

MD (EM), M.Med (FM), FACEE, FICCEM

Dr. Nisanth Menon is a Specialist in Emergency and Family Medicine with over 15 years of experience integrating primary care and acute emergency medicine. He holds academic and clinical roles across India and internationally.

Clinical expertise and leadership

Dr. Menon is a Senior Consultant and National Board accredited faculty in Emergency Medicine, with a focus on high-intensity trauma care and resuscitation. He recently completed a Global Trauma Fellowship in Rome and serves as a Designated Expert for the Government of Kerala's Action Plan on Snakebite Envenoming.

He served as a member of the WHO Working Group on Preparedness and Emergency Response (WGPR) during the COVID-19 pandemic. His fellowships include recognition from the European Society for Emergency Medicine (EUSEM) and the Academic College of Emergency Experts in India (ACEE).

Academic and research contributions

Dr. Menon has over 13 years of undergraduate and 8 years of postgraduate teaching experience, with honorary faculty positions at several institutions. His peer-reviewed research covers:

Emergency and primary care collaboration
Disaster management and climate change impacts on rural health
Snakebite mitigation and rural emergency care
Point-of-care ultrasound (POCUS) and trauma outcomes

Global health and education

Dr. Menon has been an active contributor to the WONCA family for many years, including work with WONCA Rural South Asia (WoRSA) and AFPI in organising the 15th World Rural Health Conference.

He is the lead coordinator of the RECTIFY project (Rural Emergency Care Training for Physicians), which equips primary care doctors in resource-limited settings with skills in toxicology, trauma, and resuscitation.

Beyond clinical work, Dr. Menon advocates for public health education. He has directed medical short films and organised international health film festivals. His awards include:

Taiwanese Research Award, WONCA Seoul
Healthcare Leadership Award, 15th World Rural Health Conference
President of India Award for Excellence in Scouting
Youth Leadership Award in Primary Care

Areas of professional interest

As Global Chair of the WONCA Emergency Medicine SIG, Dr. Menon focuses on:

Strengthening the interface between emergency medicine and family medicine
Advancing rural emergency care
Improving public health preparedness

His work is dedicated to making quality emergency care accessible, from tertiary trauma centres to remote rural settings.

Email Chair

Past Chair:
Dr Elena Klusova Noguiná (Spain)

Dr Elena Klusova is a Specialist in Family and Community Medicine, Consultant GP with sub-specialization in Emergency Medicine working in SAMU061 Mobile Intensive Care Unit & Helicopter Emergency Medical Service and the Emergency Department of the University Hospital Can Misses, Ibiza, Spain.

Family Medicine specialist passionate about EM, Elena always combined diverse working environments; these range from management, to working as a clinician and consultant in different hospital and out-of-hospital emergency departments and primary care settings (rural, urban, and island), to mentoring, supervising, and teaching in various institutions. Cardiopulmonary resuscitation, ECG, polytrauma, critical patient care, euthanasia, psychology, communication, skills, eHealth in emergencies and many others that go far beyond the world of EM, as Family Violence, leadership and equality issues, have been her strongest themes.

Her areas of professional interest are Emergency and Disaster Medicine, Medicine for Hostile Environments, Public Health Preparedness Systems, Rural Medicine, Medical Education, Leadership, Quality and Safety.

She is an instructor of Advanced Life Support by the Spanish Society of Intensive, Critical Medicine and Coronary Units (SEMICYUC) and her academic interests are primarily focused on medical education with teaching responsibilities at the undergraduate and graduate levels, with a particular focus on conducting face-to-face and online training interventions among physicians-in-training, senior physicians, children, and the civilian population.

Dr Klusova is one of the youngest chairs of the WONCA special interest groups, who joined the WONCA family 6 years ago, becoming a very active member of VdGM (the WONCA Europe network for GP trainees and Junior GPs - first five years after qualification as a Family Physician). Throughout these years Elena was able to serve in the WONCA Europe Conference Committee (WECC) as a representative of WONCA Europe SIGs / NETWORKS and VdGM Events officer during the past years.

Dr Klusova has been present at the birth of the WONCA SIG EM in WONCA World in Rio de Janeiro in 2016 and participated in its creation. She is the Convenor and current Chair of the Vasco Da Gama Movement Emergency Medicine Special Interest Group, stepping down shortly to support and continue motivating the young doctor's group from the position of Chair of WONCA EM SIG.

Dr Klusova works actively in several WONCA Europe networks, being a member of the EURIPA communication committee and being Social Media Manager between EM VdGM SIG and EURIPA. She is part of The WONCA Working Party on Women and Family Medicine (WWPWFM) and Rural Practice Working Party.

Co-Convenor or other office bearers

Executive Members

Membership Open?

Vision and Mission of WONCA SIG on Emergency Medicine

Objectives of the WONCA SIG on Emergency Medicine

a) Ensure strong, diverse member engagement with representation from all WONCA regions.

b) Produce urgent care/emergency medicine sessions/workshops at WONCA conferences including an approach to common office based emergencies that may arise.

c) Advocate for a strong generalist education and practice model with a wide clinical scope including emergency medicine in urban and rural settings across all WONCA regions.

d) Liaise with other WONCA working parties and SIGs to collaborate on overlapping projects.

e) Collaborate with WONCA members to develop guidelines/approaches relating to urgent/emergency care based on community need and adaptable based on local resources.

f) Investigate and collaborate on adoption of new technologies to aid in care delivery. E.g. point of care testing (working with the WONCA Point of Care SIG) and point of care ultrasound to optimize patient care and augment diagnostic abilities of general practitioners.

g) Assist WONCA in policy and advocacy activities as it relates to urgent or emergency care.

Publications & Documents

Activities

Potential Areas of Collaboration with established WONCA Working Parties and Special Interest Groups:

The SIG on conflict and catastrophic medicine and migrant health would be natural partners for collaboration. While the scope of these SIGs extends beyond clinical acute care medicine, there may be some alignment in our work plans in planning workshops and advocacy material for family doctors. There are also opportunities to work with the SIG on migrant health to provide learning opportunities and practice support materials to assist family doctors caring for displaced persons, particularly in an acute medicine setting.

Some other logical areas of collaborations are with the working party on rural practice and education working party. From the perspective of rural practice, many family doctors practice acute medicine as part of their continuing comprehensive care. As such, there would likely be a need to provide clinically relevant workshops in this area for professional development. From the education perspective, the SIG can assist advocacy in family medicine training to include multiple domains of care including acute care medicine such that family doctors who graduate from training have the necessary knowledge (competencies) to practice full scope and able to respond to community needs.

There would also be an opportunity to partner with the Working party on mental health. As acute mental health and addiction conditions are seen in urgent care/emergency medicine settings, discussions regarding the care of these patients are important. The development of standards or a guidance document may help our colleagues in practice - ensuring safe and compassionate care. Finally, the concept of transition of care between family doctors in the emergency department and the clinic could be explored. This would be particularly important for patients receiving palliative care or elderly patients. Collaboration and joint projects can be undertaken with the respective SIGs to address this.