Tsiftsis Dimitrios, Ulrich Andrew, Notas George, Patrikakou Anna, Reid Eleanor
Emergency Department, Nikaia General Hospital, D. Mantouvalou 3, Nikaia, 18454, Greece.
Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Avenue, Suite 260, New Haven, CT, USA.
Int J Emerg Med. 2024 Apr 3;17(1):46. doi: 10.1186/s12245-024-00622-4.
Greece is a parliamentary republic in southeastern Europe populated by over 10 million permanent residents: 9 million reside on the mainland, with almost 4 million in the greater Athens area. The remaining 1 million populate the over 1200 Greek islands. In addition, more than 160,000 asylum-seekers reached Greece in 2022, and more than 25 million tourists have visited Greece in the last two years. Modern Greek Emergency Medicine (EM) is now in its 4 decade. The Greek government has focused the last few years on enhancing the quality of emergency services provided in public hospitals. Emergency Departments (EDs) are being modernized, undergraduate medical education gradually incorporates EM, and a specialty training program in emergency nursing has been established. However, the late recognition of the critical importance of EM as a specialty in Greece has resulted in the subsequent need to create three alternative pathways to EM, none of which are direct from residency. The first is a 24-month Emergency Medicine fellowship after completing a residency in another specialty and then passing the national exam. The second is for physicians who have worked in a public hospital ED (Gr: Ethniko Systima Ygeias (ESY) ESY for at least three years and successfully passed the national exam. The third, which no longer exists, is a 'grandfather' pathway for those physicians who worked in an ESY ED for five years prior to the creation of the fellowship training program. As a result, there is a critical shortage of EM-trained physicians, resulting in most care being provided by physicians without formal training in EM. This is further confounded by the country's challenging geography, with frequent air transfers from the islands to mainland hospitals. Creating an EM Residency training program is a critical next step to overcoming many of the challenges facing EM provision in Greece today: it would address the shortage of EM-trained providers, decrease the need for costly ground and air transfers, and improve the quality of emergency care throughout Greece.
希腊是欧洲东南部的一个议会制共和国，有超过1000万常住人口：900万居住在大陆，近400万在大雅典地区。其余100万居住在1200多个希腊岛屿上。此外，2022年有超过16万寻求庇护者抵达希腊，在过去两年中有超过2500万游客到访希腊。现代希腊急诊医学（EM）如今已发展到第4个十年。希腊政府在过去几年一直专注于提高公立医院提供的急诊服务质量。急诊科正在进行现代化改造，本科医学教育逐渐纳入急诊医学内容，并且已经建立了急诊护理专业培训项目。然而，希腊对急诊医学作为一个专科的至关重要性认识较晚，导致随后需要创建三条通往急诊医学的替代途径，其中没有一条是直接从住院医师阶段开始的。第一条途径是在完成另一个专科的住院医师培训并通过国家考试后，参加为期24个月的急诊医学进修项目。第二条途径适用于那些在公立医院急诊科（希腊语：Ethniko Systima Ygeias (ESY)）工作至少三年并成功通过国家考试的医生。第三条途径（现已不存在）是针对那些在进修培训项目设立之前在ESY急诊科工作五年的医生的“祖父条款”途径。结果，经过急诊医学培训的医生严重短缺，导致大多数护理工作由没有接受过急诊医学正规培训的医生提供。该国具有挑战性的地理环境使情况更加复杂，经常需要将患者从岛屿空运到大陆医院。创建急诊医学住院医师培训项目是克服当今希腊急诊医学面临的许多挑战的关键下一步：它将解决经过急诊医学培训的医疗人员短缺问题，减少对昂贵的地面和空中转运的需求，并提高希腊各地的急诊护理质量。
