GLOBAL STANDARDS, LOCAL IMPACT: ONE-YEAR OUTCOMES OF A COMPETENCY-BASED EMERGENCY MEDICINE PROGRAM IN PAKISTAN

Abstract

Background: Since there is no standardization of emergency care systems, low resource areas also tend to have large clinical outcome disparities. In order to enhance the care, at a tertiary care hospital in Lahore, Pakistan, a systematic, competence-based emergency medicine training program was conducted. While undertaking these reforms the program aimed at modernization of emergency medicine to the international ideals and improving the patient care standard within the constraints of resources.

Methods: A mixed-methods cross-sectional study was conducted in the Emergency Department of a tertiary care hospital in Lahore, spanning January 2023 to January 2024. Thirteen physicians completed a one-year modular training program based on globally recognized resources, including Tintinalli’s Emergency Medicine, UpToDate, and MDCalc. The curriculum incorporated practical training in managing high-acuity conditions such as cardiac arrest, trauma, and stroke. Participants were required to obtain certifications in ACLS, BLS, and ATLS. Quantitative evaluation was performed using a structured questionnaire covering domains such as clinical confidence, procedural skills, interdepartmental communication, and perceived patient outcomes. Qualitative feedback was also gathered to capture experiential insights.

Results: Of the participating physicians, 84.6% reported increased confidence in clinical decision-making, while 76.9% noted improved procedural competency. Enhanced interdepartmental communication was reported by 69.2% of respondents, and 61.5% observed better patient outcomes. The qualitative data emphasized the importance of simulation-based training, exposure to real-time clinical scenarios, and the integration of point-of-care ultrasound. Broader system-level improvements included better diagnostic utilization, increased patient flow, and closer adherence to international emergency care protocols.

Conclusion: The implementation of a structured emergency medicine training program was associated with marked improvements in individual clinical skills and system efficiency. While challenges such as limited time for training and the need for sustained mentorship persist, the findings support wider adoption and integration of such programs into national medical education strategies. Continued evaluation and scaling may strengthen emergency care delivery across similar low- and middle-income settings.