Starting Anew: Returning to the Pediatric Emergency Department as the First and Only Trained Pediatric Emergency Medicine Specialist

doi:10.1016/j.cpem.2011.12.001

Clinical Pediatric Emergency Medicine

Volume 13, Issue 1, March 2012, Pages 12-17

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Formal pediatric emergency medicine training did not exist in Australia in the late 1980s, so I ventured overseas to gain experience and knowledge from the then leaders in the field. I completed my fellowship and returned to an emergency department (ED) in Australia as the only pediatric emergency medicine–trained attending. This article describes my experiences in transforming an ED run solely by residents into one with now 14 full-time consultants and our own fellows. Imbedded in this story is the experience of one of our first fellows who came from Switzerland, where even emergency medicine was not yet a recognized specialty. On his return home, he too transformed his ED.

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Issues I Had to Deal With When I Got Home

Trauma care was a major issue for the hospital. Trauma centers had not yet been established in Victoria in the early 1990s, but most major pediatric trauma was coming to RCH. Because we did not have adequate senior physician coverage in the ED after I returned, the pediatric intensive care unit (PICU) consultants decided that all trauma should be managed by them and that patients would bypass the ED and go straight to the PICU. This involved transferring a severely injured child up 2 floors in

One of Our PEM Trainees Returns to Start Anew in Switzerland

In February 1999, my wife, our 2 children, and I flew from Zurich to Melbourne. I had been lucky enough to get a position on a local salary as a fellow in PEM at RCH. At the time, I was a consultant in general pediatrics at the Children's Hospital of Zurich. I had 7 years of training in pediatrics, and I always enjoyed working in the ED. In our hospital, which has been the biggest pediatric tertiary care hospital in Switzerland, the ED functioned like all others in the country. The patients

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