- Uganda Certificate of Education (UCE) or its equivalent with at least 5 passes
- Uganda Advanced Certificate of Education (UACE) or its equivalent with at least 2 principal passes.
- An Honors degree from an accredited degree awarding institution
- Candidates who have a Pass degree should have at least a Postgraduate Diploma with at least a credit from an accredited degree awarding institution.
Additionally, for international applicants:
- Applicants whose first language or medium of instruction is not English, must provide evidence from a recognized English language training institution that they have sufficient command of English language.
- Applicants should have their documents verified by NCHE.
- Applicants should have their degree certificate and transcript translated and converted into an equivalent of Ugandan Universities’ CGPA
For applicants to clinical programmes;
-
- Have documentary evidence of Internship Training indicating disciplines and dates.
- Be registered or eligible for registration with Uganda Medical and Dental Practitioners Council.
- A current certificate of good standing with the Medical Practitioners’ Council of the country of origin.
An honors in Bachelor of Medicine and Bachelor of Surgery.
A year of post internship experience relevant to Emergency Medicine
Evidence of an excellent general knowledge base of medicine assessed by a pre-course paper
Code |
PROGRAMME |
DURATION |
UGANDAN STUDENTS |
|
INTERNATIONAL STUDENTS |
|
|
|
|
TUITION (SHS.) per Semester |
FUNCTIONAL FEES (SHS.) per year |
TUITION (SHS.) per Semester |
FUNCTIONAL FEES (SHS.) per year |
MMED |
Master of Medicine in Emergency Medicine |
3 |
1,400,000 |
1,270,000 |
2,800,000 |
2,540,000 |
Other Fees | ||
ITEM | Ugandan | International |
NCHE | 20,000 | USD. 50 |
Smart ID Card | 33,000 | USD. 10 |
Application Fees Undergraduate | 50,000 | USD. 50 |
Application Completion programmes | 80,000 | USD. 50 |
Application Fees Postgraduate | 50,000 | USD. 50 |
Application Fees PHD | 100,000 | USD. 100 |
Certification Fees | 3,000 | |
Graduation Fees | 20,000 | USD. 50 |
Transcript Fees | 25,000 | USD. 50 |
Certificate Fees | 25,000 | USD. 50 |
Partial Transcript | 20,000 | USD. 10 |
Convocation | 10,000 | USD. 50 |
Retake Fees | 30,000 | USD. 10 |
Application Fees for Change of Programme | 10,000 | USD. 10 |
Replacement of Admission Letter | 10,000 | USD. 10 |
EXECUTIVE SUMMARY
This 3-year Master of Medicine (MMed) Programme for Emergency Medicine is the first of its kind in Uganda but is part of an integrated development of Emergency Care supported by the Ministry of Health. Following recognition of the gap in trained Human resource for Emergency care delivery in Mbarara and nationwide, the Ministry of Health committed itself in June 2015 to train 190 Emergency Physicians to firmly establish the new specialty in Uganda. This gap in hospital emergency care services has to be filled as soon as possible to reduce preventable morbidity and mortality amongst emergency patients with various presentations including trauma, maternal and child health, and emergencies arising from non-communicable diseases.
Candidates in Emergency Medicine rotate through a structured programme designed to make sure that their training is in line with international standards. Some aspects of training overlap with the Emergency components of the training of colleagues in Surgery, Anaesthetics, Adult and Paediatric Medicine. This curriculum has deliberately been designed to encourage learning alongside colleagues of other specialties, as teamwork is one of the hallmarks of the practice of Emergency Medicine. Integration with existing MMed programmes also makes this program deliverable and cost-effectively started the program in 2017/18 with a full-time visiting lecturer in Emergency Medicine provided by AIM International to anchor the training. The AIM lecturer has since scaled back his engagement to part-time (Visiting lecturer). MUST has retained one graduate of the program as a full-time assistant lecturer and acting Head of the Department. The full-time faculty is supported by other visiting Emergency Physicians through existing partnerships with Seed Global Health, Global Emergency Care, and Massachusetts General Hospital. The program projects to admit 8 students per year.
Programme Overview
1.5.1 Introduction
Emergency Medicine (EM) is a rapidly expanding and stimulating specialty concentrated upon the urgent initial diagnosis and treatment of acute illness and injury. The EM specialty started in the 1950s and 1960s in the USA and UK respectively, when physicians realized that the initial management of acute illnesses and injuries needed to be supervised by specialized doctors to improve the outcome of the first few critical hours of emergency treatment. The EM specialty is recognized internationally, with an African Federation for Emergency Medicine (AFEM) founded in 2009 to bring together Emergency Medicine Specialist societies from all over Africa.
The role of Emergency medicine is immediate assessment, resuscitation, and treatment of all patients with acute serious life-threatening illnesses and injuries. EM physicians must be able to adequately and promptly identify and treat critically ill and injured patients of all age groups, and a wide range of pathology including both medical and surgical life-threatening conditions. The structure of the MMed EM curriculum is based on that recommended by the Royal College of Emergency Medicine (RCEM) in the UK and the African Federation of Emergency Medicine (AFEM), and also incorporates common course modules being taught to residents in other programmes at MUST.
It is designed to produce Emergency physicians with expert knowledge on a wide range of medical and surgical emergency patient presentations, diverse diagnostic skills such as X-ray and CT imaging, ultrasound, ECG interpretation, etc., and practical skills needed to resuscitate patients.
Additionally, the EM physicians are equipped with leadership and communication skills to provide multidisciplinary team leadership to improve the survival of patients after resuscitation. The physicians are also expected to be competent in planning for definitive care, which involves working with other in-patient specialties as well as primary care and pre-hospital services.
Emergency medicine is practiced in an ED, which is typically divided into a triage area, resuscitation rooms, procedure/plaster rooms, and ambulatory care sections. In addition to adult facilities, many emergency departments have dedicated facilities and staff for children. Some EDs have observation wards/clinical decision units where further care and testing take place for a short period of time under the guidance of the Emergency Physician until patients can be safely discharged home or to other in-patient care units. The ED at MRRH is the primary clinical teaching space for the MMED EM program at MUST, with a goal to transform that department into a fully equipped ED staffed with qualified and licensed Emergency physicians and other trained emergency teams.
1.5.2 Programme justification
Globally, the top leading causes of mortality and morbidity are conditions with potential emergent manifestations of acute decompensation that must be addressed within hours to days of onset.
These include ischemic heart disease, cerebrovascular diseases, and lower respiratory infections. In Africa, mortality and morbidity due to emergency conditions are mainly attributed to trauma (9%) and communicable diseases (52%), with an increasing burden due to non-communicable diseases (Chang et al, 2016). In Uganda, the top leading causes of mortality include neonatal disorders, lower respiratory tract infections, malaria, TB, HIV, diarrheal diseases, stroke, and ischemic heart diseases (Global Burden of Disease, Uganda, 2019). Mortality and morbidity from these conditions are preventable from timely and appropriate emergency care. Despite a high burden of emergency conditions in low-income countries (LICs) with median DALYs of 47,728 per 100 000 population compared to 15,691 in high-income countries (HICs), emergency usage rates are low in LICs (8 visits per 1000 population) compared to HICs (264 visits per 1000 population).
In Uganda, deaths, and DALYs due to Emergency conditions are reported at 1,191 and 52,441 per 100,000 populations respectively with only 11 per 1000 people utilizing emergency care services (Chang et al, 2016). This disparity is attributed to the limited access to emergency care services in LICs.
The gap in emergency care and the need for Emergency specialists in Uganda has been recognized both in Mbarara district and at the National level by the Ministry of Health (MOH). With the goal to improve emergency care in the country, a department of Emergency Medical Services (EMS) was established under the MOH. The MMed program in Emergency Medicine is one of the initiatives supported by the EMS department, with other ongoing developments to train pre-hospital emergency care cadres, mid-level hospital emergency care practitioners, and other in-service emergency care staff training. Training clinician specialists, EM faculty, and EM leadership through this MMed in EM course will be key in establishing and coordinating a functional Emergency care service to reduce preventable morbidity and mortality from Emergency conditions.
The provision of emergency care by trained providers has been shown in over 250 scientific studies to improve patient outcomes (Holliman, International Journal of Emergency Medicine 2011).
When patients with communicable diseases, such as pneumonia, meningitis, malaria, and diarrhea, receive early medical care, they experience significantly less morbidity and mortality. Multiple studies have demonstrated that over fifty percent of the children who die in African Hospitals do so within the first forty hours after admission. Additionally, when parents understand that their children will receive prompt high-quality care, they are more likely to present to the hospital for treatment. (Kissoon, Paediatric Critical Care Med 2011).
1.5.3 Careers and employment opportunities
The MMed in Emergency medicine program at MUST was the first of its kind in Uganda starting in 2018, with a parallel course starting at Makerere University in 2019. The Ministry of Health recently recommended that 190 Emergency specialists are trained and recruited as soon as possible, and has agreed to recognize Emergency Medicine as a postgraduate medical specialty. The training and employment of Emergency Care Specialists will help the MOH to meet its commitment to improving Emergency Care within Uganda.
The program also emphasises leadership and faculty mentorship, so in addition to taking on clinical care roles in both public and private health facilities, graduates will be able to pursue academic careers and program management roles within emergency care.
Sample Job description for the Emergency physician
The EM physician will be expected to work with other medical and surgical specialists, and the hospital medical director to ensure that the Emergency services are delivered in line with best practice as per locally and nationally agreed-upon policies, procedures, and standards.
Licensure/ Certification: EM Physicians will be fully registered with the Uganda Medical and Dental Practitioner Council (UMDPC) as a specialist, and will have completed Advanced Life Support Courses with up-to-date International or equivalent local certification.
Clinical: EM Physicians will be expected to provide excellent clinical leadership, consultant delivered care, and consultant-led review. Direct clinical care consists of the coordination of assessment and treatment of patients that present to the ED in cooperation with the senior nurse in charge. This includes general flow management, and supervision of clinical staff on duty including interns, nurses, and other cadres to expedite timely resuscitation, diagnosis, and referral/discharge of Emergency patients. These duties are to be shared with the other specialist Emergency Physicians employed by the institution.
Training: Dedicated bedside teaching during clinical shifts, including morning 'handover' teaching rounds, clinical assessments, simulation, mini-lectures, etc. for residents, interns, and other staff rotating through the Emergency Department. In academic institutions, the post holder will teach and examine the Emergency Medicine MMed and other Emergency Medicine courses, as agreed with the Head of Department. This will involve bedside teaching, lectures, tutorials, practical demonstrations, and simulation.
Clinical Administration: Includes results follow-up, overnight attendance reports, incident and complaint management, referral troubleshooting, general flow troubleshooting, and off-shop floor workplace-based assessments (case-based discussions). Audit, quality improvement, research, and dissemination of research findings to the wider team and the hospital.
Advocacy: To advocate for and develop Emergency Medical services and care both locally and nationally by contributing to planning Emergency Services, and training Emergency Services staff, as arranged between the individual, Head of EM Department, and national bodies.
Special interest: The post holder may develop and practice a special interest within the field of Emergency Medicine such as paediatrics, toxicology, etc. as a teaching or research interest. This area of additional expertise will depend on local needs, the experience of the post holder, and negotiation. It is advised that an EM specialist should spend at least 50% of professional time in general frontline Emergency practice.
Overall Aim of the Program
This curriculum sets out to provide Emergency Physicians with the knowledge and expertise to be safe, expert, and independent practitioners functioning at the consultant level within the Ugandan, the African continent, and beyond.
Specific Objectives
- To produce confident, inquisitive, and adaptable Emergency Physician leaders capable of teaching, and mentoring peers and juniors.
- To foster MMed students’ mastery of the knowledge, skills, and attitudes required for the safe and effective practice of Emergency Medicine.
- To build the students’ clinical, academic, and administrative skills necessary to become future leaders in the field of Emergency Medicine.
- To produce Emergency Physicians empowered with the guiding principles of research methodology and interest them in building a quality emergency care evidence base.
Learning Outcomes
Upon completion of training, students shall;
- Be competent specialists in Emergency Medicine, capable of assuming a consultant role in the specialty
- Possess organisational skills in ED management and disaster management, and the ability to play a leadership role in the development and organisation of Emergency Medical Services and Pre-hospital Care
- Employ relevant methods of prioritisation, assessment, intervention, resuscitation, and further management of patients to the point of disposition
- Be able to use preventive and therapeutic interventions effectively including procedures in a safe, appropriate, and timely manner
- Function in a multidisciplinary clinical team and have the ability to seek appropriate consultation from other health professionals, recognizing the limits of their own expertise
- Demonstrate effective communication skills, rapport, trust and positive ethical and therapeutic relationships with patients and their families
- Be able to carry out quality improvement and research projects relevant to their roles in the Emergency care setting.
Innovations
The innovations that will be used in EM training include; Teaching through Simulation, remote teaching using virtual platforms like Zoom, Google classroom, MS Teams and WhatsApp discussions; Directly Observed Procedural Skills (DOPS); and Point of Care Ultrasound for bedside clinical decision making in the ED.
There will be physical Mentorship for each year of study, medical education mentorship, and objective feedback sessions between faculty and students during the semester. Virtual on-job mentorship will be provided for health workers across the country using the “Hub and Spoke” approach, mostly led by the students.
In addition, EM being a young specialty in Uganda, it is expected that as the course progresses, the scope of practice and the unique contribution of the specialty to better functioning of Emergency care within a specific Ugandan context will become clear. It is one of the stimulating features of the specialty that the shape of the service is determined by the health care needs of an individual setting. It is expected continuous qualitative and quantitative assessment will be done on the clinical outcomes and impact of the training program.
Curriculum structure
LH=Lecture hours PH=Practical hours CH=Contact Hours CU=Credit Units
YEAR 1 SEMESTER 1 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM7101 |
Principles of Emergency Care |
Core |
15 |
90 |
30 |
75 |
5 |
EM7102 |
Anatomy for the Emergency physician |
Core |
30 |
30 |
30 |
60 |
4 |
EM7103 |
Acute Illness Pathophysiology |
Core |
15 |
30 |
90 |
75 |
5 |
EM7104 |
Acute Illness Pharmacology |
Core |
15 |
20 |
40 |
45 |
3 |
Total credit unit |
17 |
YEAR 1 SEMESTER 2 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM7201 |
Anaesthesia for Emergencies |
Core |
15 |
80 |
40 |
75 |
5 |
EM7202 |
Applied Microbiology, Immunology, Infectious disease |
Core |
10 |
30 |
40 |
45 |
3 |
EM7203 |
Emergency Radiology |
Core |
18 |
82 |
32 |
75 |
5 |
EM7204 |
Toxicology, Envenomation and Environmental emergencies |
Core |
17 |
70 |
46 |
75 |
5 |
Total credit unit |
18 |
YEAR 1 RECESS TERM |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM7301 |
Ethics, Professionalism & Medical teaching |
Core |
15 |
60 |
30
|
60 |
4 |
EM7302 |
Practical Management of Resuscitation |
Core |
05 |
60 |
20 |
45 |
3 |
Total credit unit |
7 |
YEAR 2 SEMESTER 1 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM8101 |
Traumatology for the Emergency Physician |
Core |
15 |
60 |
60 |
75 |
5 |
EM8102 |
Emergency General Surgery and Urology |
Core |
20 |
70 |
40 |
75 |
5 |
EM8103 |
Emergency Obstetrics and Gynaecology |
Core |
15 |
50 |
40 |
60 |
4 |
Total credit unit |
14 |
YEAR 2 SEMESTER 2 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM8201 |
Critical care for the Emergency Physician |
Core |
15 |
70 |
50 |
75 |
5 |
EM8202 |
Adult Medical Emergencies |
Core |
15 |
60 |
60 |
75 |
5 |
EM8203 |
Adult Medical Neurological Emergencies and Emergency psychiatry |
Core |
15 |
60 |
60 |
75 |
5 |
Total credit unit |
15 |
YEAR 2 RECESS TERM |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
MPH 7101 |
Epidemiology |
Core |
45 |
30 |
00 |
60 |
4 |
MPH 7102 |
Biostatistics |
Core |
30 |
42 |
18 |
60 |
4 |
MPH 7103 |
Research Methods and Survey Design |
Core |
45 |
00 |
00 |
45 |
3 |
Total credit unit |
11 |
YEAR 3 SEMESTER 1 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM9101 |
Emergency Paediatrics |
Core |
15 |
90 |
30 |
75 |
5 |
EM9102 |
Emergency medicine for Subspecialties |
Core |
15 |
60 |
30 |
60 |
4 |
EM9103 |
Health Systems Management and Disaster preparedness |
Core |
30 |
20 |
40 |
60 |
4 |
EM9104 |
Scientific writing and Research Proposal Presentation |
Core |
15 |
70 |
50 |
75 |
5 |
Total credit unit |
18 |
YEAR 3 SEMESTER 2 |
|||||||
Course code |
Course name |
Status (Core or elective) |
LH |
PH |
TH |
CH |
CU |
EM9201 |
Elective Placement |
Core |
00 |
90 |
60 |
75 |
5 |
EM9202 |
Thesis development and dissertation defence |
Core |
00 |
90 |
60 |
75 |
5 |
EM9203 |
Introduction to Pre-Hospital Critical Care Retrieval and Transfer |
Core |
00 |
90 |
00 |
45 |
3 |
Total credit unit |
13 |