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Program Overview

The Certification Program in Emergency Medicine (CPEM) is a 12-month competency-based training initiative, crafted to empower physicians working in Emergency Departments (EDs) with the essential knowledge and clinical expertise required to excel in emergency care. Developed by leading Emergency Medicine (EM) experts at Indus Hospital and Health Network (IHHN, Karachi), in collaboration with Brigham and Women’s Hospital, a teaching affiliate of Harvard Medical School (Boston, USA) this groundbreaking program was inaugurated at Indus Hospital and Health Network in July 2018.

The program is currently guided by the expertise of EM faculty from IHHN and the University of Pennsylvania (UPenn). Notably, CPEM has already seen the successful graduation of three cohorts, and the third cohort included learners from Pakistan and Bangladesh. CPEM is strategically tailored to uplift middle-tier EM physicians, providing them with a robust education in evidence-based emergency care and setting new standards in the field.

CPEM has been recognized by both the national and international scientific community as a one-of-a-kind course to bridge the gap in emergency medicine in LMICs, along with significant improvements in clinical metrics and outcomes. [1,2]

Milestones Achieved

CPEM is the first of its kind; capacity building certification program for middle tier physicians working in the Emergency Departments.
  • Three cohorts of students have graduated successfully.
  • TCPEM batch of 2021 included candidates both from Pakistan and Bangladesh. Hosting institutes were the Indus Hospital and Health Network (Pakistan) and Dhaka Medical College (Bangladesh).
  • CPEM graduates include doctors both from public and private sector Emergency Departments.
  • The program involved more than 100 physicians in total spread across two countries.
  • Graduates are enrolled as teaching faculty/ facilitators in CPEM.
  • Graduates of CPEM are now enrolled in EM training programs in Pakistan and abroad.
  • Graduates of CPEM have successfully cleared fellowship programs (MRCCEM/FCPS).
  • Graduates are providing services in well reputed hospitals worldwide.
  • Through efforts in clinical research capacity building, CPEM graduates have published scientific literature in well reputed journals (EXAMPLES/CITATIONS).
Eligibility Criteria
  • Medical graduates from recognized medical colleges, both from Pakistan and abroad
  • Minimum of One-year clinical working experience in the Emergency Department required
Learning Objectives
By the end of One-year of the certification program learners would be able to:
  1. Organize clinical management of critically ill patients presenting to the Emergency Department.
  2. Implement evidence-based Emergency Medicine in their centers.
  3. Practice life-saving procedures in Emergency Department (within institutional guidelines).
  4. Define indications, contraindications and complications of life saving procedures.
  5. Interpret Emergency Medicine based research.
  6. Execute scholarly work.
  7. Implement ED patient safety and quality improvement for improved patient outcome.
  8. Present case reviews.
  9. Participate in Emergency Medicine Journal clubs.
  10. Participate in morbidity and mortality meetings to stay up to date in the latest advancements in Emergency Medicine.
Of note: CPEM does not provide credentialing in specific procedures; graduates should follow their institutional protocols regarding supervision and credentialing.

Curriculum

One-year CPEM curriculum has been comprehensively designed to encompass core competencies of Emergency Medicine. It is shared with the learners at the beginning of the year.

Mode of Learning

Virtual Learning: Keeping in mind the principles of adult learning, we utilize flipped classrooms as an instructional approach. CPEM is delivered online via scheduled Zoom meetings once a week for the entire year. CPEM utilizes a learner-centered approach through Google Classroom. Students have access to block-related study materials and engage in online discussions, activities, review videos and PowerPoint presentations, encouraging self-directed learning block-related is dedicated to collaborative discussion, problem-solving, peer-to-peer interaction, and individualized support with our diverse international and national faculty.

On-site workshops: CPEM workshops at the Emergency Department, IHHN, are conducted five times a year to equip students with hands-on practice on essential Emergency Department procedures and skills in simulation models and real-time (optional for participants outside Pakistan).
Methods of Assessment
Formative Assessment:
  1. Bi-annual feedback by supervisors
  2. Weekly online simulation assessment
  3. Logbook (maintained by candidates)
Summative Assessment:
  1. Written examination based on multiple choice questions
  2. Oral Cases (end of the year only)
Graduation Requirements
  • Learners must attend at least 70% of all conference sessions to successfully complete the certificate.
  • Learners must obtain an average score of minimum 70% (mid-term and final examination) to successfully complete the certificate.
  • Learners may receive additional conference credit points through case presentations, online running cases, reflective writing, MCQ bank development, etc. (discussed throughout the year).
Simulation Based Learning
Full Code

Full-code is a game-based clinical simulation application that is available on cellphone/tablet and PC platforms. It provides an immersive virtual emergency room environment for participants to take part in clinical simulation remotely. The participants learn whilst managing avatar based patient for a wide spectrum of common clinical problems that present to the emergency department (Pediatric and adult)
  • This is followed by a group based debriefing session, along with constructive feedback. The discussion is led by the faculty taking into account the local factors secondary to socioeconomic and geopolitical differences; impacting patient outcomes.
  • Learners are given access to full code to enable self directed learning all year around.
  • Full code has been one of the most popular components amongst learners, as it helps to identify the gaps in knowledge and boosts confidence. Being online, learners are able to participate remotely with ease.
For further information please visit
https://fullcodemedical.com/

Affinity

A simulated, web-based environment where learners have the opportunity to practice the application of their medical knowledge and decision-making. It is an interactive teaching and learning tool that uses images, video and audio recordings to simulate real-world experiences. Through self-evaluation, learners have the ability to evaluate their knowledge using inquiries with real-time feedback. Scoring is used to evaluate the performance of each individual learner as well as a group of learners which is shared with them as part of their continuous evaluation.

For further information please visit
https://affinitylearning.ca/

Eligibility Criteria

  • Medical graduates both from Pakistan and abroad
  • Applicants should have a minimum of 1 year clinical working experience

Learning Objectives

By the end of 1 year of the certification program learners would be able to;

  1. Improve clinical management of critically ill patients presenting to the Emergency Department.
  2. Practice life saving procedures knowing their indications, contraindications and complications.
  3. Develop interest in Emergency Medicine based research and produce scholarly work.
  4. Ensure ED patient safety and quality improvement for better patient outcome.

Participate in journal clubs and morbidity & mortality meetings to stay up to date in latest advancements in Emergency Medicine.

Methods of Assessment

Formative Evaluation:

  1. Quarterly feedback by supervisors
  2. Weekly online simulation evaluation
  3. Logbook filled out by the candidates detailing procedures.

Summative Evaluation:

  1. Multiple choice questions.
  2. Oral Cases and Objective structured clinical exam.

Graduation Requirements

  • Learners must attend at least 70% of all conference sessions to successfully complete the certificate.
  • Trainees can receive additional conference credit through a variety of mechanisms (i.e. giving presentations, running cases on WhatsApp, doing a reflective writing piece, writing MCQs, etc.) that will be discussed throughout the year
  • Obtain an average score of at least 70% (mid-term & final examination) to successfully complete the certificate.

Simulation Based Learning

Full Code

Full-code is a game-based clinical simulation application that is available on cellphone/tablet and PC platform. It provides an immersive virtual emergency room environment for participants to take part in clinical simulation remotely. The participants get to manage the avatar based patient for a wide spectrum of common clinical problems that present to the emergency department, including both, pediatric and adult patient scenarios.
A group based debrief and discussion is done by the faculty taking into account the local factors & variations due to socioeconomic and geopolitical differences. This has been one of the most popular components for participants in previous cohorts, as it helps to identify the gaps in knowledge and boosts confidence in the participants. At the same time, being online, it helps reduce the cost of travel, and logistics that a learner would have to bear for attending a simulation session in-person.

Affinity

A simulated, web-based environment where learners have the opportunity to practice the application of their medical knowledge and decision-making.  It is an interactive teaching and learning tool that uses images, video and audio recordings to simulate real-world experiences. Through self-evaluation, learners have the ability to evaluate their knowledge using inquiries with real-time feedback. Scoring can also be used to evaluate the performance of each individual learner as well as group of learners which is later shared with them as part of their continuous evaluation.

Please visit Affinity Learning for more information

Researches

  • Saleem, Syed & Haider, Kaniz & Salman, Saima & Samad, Lubna & Yasin, Zayed & Rybarczyk, Megan. (2020). Bridging the Gap in Emergency Medicine in Pakistan. Western Journal of Emergency Medicine. 21. 10.5811/westjem.2019.10.44502.
  • Kemmler, Charles & Saleem, Syed & Ali, Saima & Samad, Lubna & Haider, Kaniz & Jamal, Mohammad & Aziz, Tariq & Maroof, Quratulain & Dadabhoy, Farah & Yasin, Zayed & Rybarczyk, Megan. (2021). A One‐year Training Program for Physicians in Emergency Medicine in Karachi, Pakistan: Evaluation of Learner and Program Outcomes. AEM Education and Training. 5. 10.1002/aet2.10625.
  • Mukhtar, Sama & Saleem, Syed & Ali, Saima & Ahmed, Sarfaraz & Yaffee, Anna. (2021). Standing at the edge of mortality; Five-year audit of an emergency department of a tertiary care hospital in a low resource setup. Pakistan Journal of Medical Sciences. 37. 10.12669/pjms.37.3.3680.
  • Salman, Saima & Saleem, Syed & Shaikh, Quratulain & Yaffee, Anna. (2019). Epidemiology and outcomes of trauma patients at The Indus Hospital, Karachi, Pakistan, 2017 – 2018. Pakistan Journal of Medical Sciences. 36. 10.12669/pjms.36.ICON-Suppl.1717.
  • Saleem, Syed & Ali, Saima & Ghouri, Nida & Maroof, Quratulain & Jamal, Muhammad & Aziz, Tariq & Shapiro, David & Rybarczyk, Megan. (2021). Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pakistan Journal of Medical Sciences. 38. 10.12669/pjms.38.ICON-2022.5785.

Faculty

Dr. Syed Ghazanfar Saleem
Dr. Megan Rybarczyk
Dr. Saima Ali
Dr. Sama Mukhtar
Dr. Adeel Khatri
Dr. Rabia Bega

Starting Date: Ocobert 4, 2023
Last Date to Register: September 18, 2023

National Student's Fee Structure:

Step 01

Registration fee: PKR 2000 (non-refundable)
First: Pay Registration Fee
Second: Fill Registration Form

Step 02

Option 1
Full certificate (3 Modules and 4 workshops) PKR 100,000
Option 2
Each module separately (excluding workshops) PKR 40,000.
Candidates can enroll in up to 2 modules at a time. In case of opting for 3 modules, Option 1 will suffice.

International Student's Fee Structure:

Step 01:

Registration fee: US $ 10 (non-refundable)
First: Pay Registration Fee
Second: Fill Registration Form

Step 02:

Option 1

Full certificate (3 Modules and 4 workshops) USD $ 1500

Option 2

Each module separately (excluding workshops) USD $ 500

Candidates can enroll in up to 2 modules at a time. In case of opting for 3 modules, Option 1 will suffice.

………….

For candidates applying from LMIC, a 50% fee waiver will be provided, applicable for the whole course (Option 1) and per module.

This will not include the in-person workshops. If the candidates are present in Pakistan at the time of the workshop, they will be able to join.

Course Directors

Dr. Sama Mukhtar – MBBS, FCPS, GCSRT, MHPE Scholar (AKU)
Dr. Megan Rybarczyk – MD, MPH, FACEP

Course Co-Ordinator

Rabia Bega – MBBS

For Any Query

Contact at: cpem@tih.org.pk

C-PEM Faculty

C-PEM International Faculty

Testimonials

Dr. Agha Abdul Wasey Durrani

“I joined CPEM while attempting my MRCEM exams. Being a doctor in a non-training post, I got to learn from a diverse array of EM Physicians. The forum not only gave us international exposure with their exceptional faculty but also nurtured an understanding of the need for EM in Pakistan. Concepts that I had hitherto never even heard of – were not only introduced but also explained. The program helped integrate connections between EM physicians from different institutes and I can say without a doubt, that it was an invaluable experience in shaping who I am today. IHHN EM faculty will always hold a special place in my heart.”

Dr. Muhammad Asif Yasin

“CPEM has had a positive impact on my clinical knowledge and skills,

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