title: An international fellowship training program in pediatric emergency medicine: establishing a new subspecialty in the Land of the Dragon.
abstract: BACKGROUND
  The health care system reform in the People's Republic of China has brought plans for establishment of a universal coverage for basic health services, including services for children. This effort demands significant change in health care planning. Pediatric emergency medicine (PEM) is not currently identified as a specialty in China, and emergency medicine systems suffer from lack of appropriate training.In 2006, the Centre for International Child Health and the Department of Pediatrics, British Columbia Children's Hospital, Vancouver, Canada, initiated a fellowship training program in PEM for pediatricians working in emergency departments or critical care settings with the Children's Hospital of Fudan University, China. The main objective was to upgrade the professional and clinical experience of emergency physicians practicing PEM and build PEM capacity throughout China by training the future trainers.
  
  
  METHODS
  After selecting trainees, the program included a structured curriculum over 2 years of training in China by Canadian and Australian PEM faculty and then practical exposure to PEM in Canada. All trainees underwent a structured evaluation after their final rotation in Canada.
  
  
  RESULTS
  A total of 12 trainees completed the first 2 program cycles. The trainees considered the "overall rating of the training experience" as "excellent" (10/12) or "good" (2/12). All trainees considered the program as a relevant training to their practice and felt it will change their practice. They reported the program to be effective, with excellent complexity of content.
  
  
  CONCLUSIONS
  Despite its current success, the program faces challenges in the development of the new subspecialty and ensuring its acceptance among other health care providers and decision makers. Identification and preparation of a capable training force to lead educational activities in China are daunting tasks. Time constraints, funding, and language barriers are other challenges. Future effort should be focused on improving and sustaining resuscitation capacity and enhancing triage systems.
authors.affiliation: Division of Pediatric Emergency Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada. rgoldman@cw.bc.ca
authors.forename: Ran D
authors.initials: RD
authors.lastname: Goldman
authors.forename: Adam
authors.initials: A
authors.lastname: Cheng
authors.forename: Anna
authors.initials: A
authors.lastname: Jarvis
authors.forename: Kelly
authors.initials: K
authors.lastname: Keogh
authors.forename: Guo-ping
authors.initials: GP
authors.lastname: Lu
authors.forename: Jian-she
authors.initials: JS
authors.lastname: Wang
authors.forename: Niranjan
authors.initials: N
authors.lastname: Kissoon
authors.forename: Charles
authors.initials: C
authors.lastname: Larson
mesh_terms: D001315:Australia; D002170:Canada; D002681:China; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education* / Q000458:organization & administration; D004636:Emergency Service, Hospital; D005257:Fellowships and Scholarships / Q000458:organization & administration*; D005544:Forecasting; D005550:Foreign Medical Graduates; D006291:Health Policy; D006301:Health Services Needs and Demand; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007391:International Cooperation; D010372:Pediatrics / Q000193:education*; D015397:Program Evaluation; D011640:Public Policy; D013222:State Medicine / Q000458:organization & administration; D000078329:Workforce