# Talk:International emergency medicine

Moved to talk because no references and likely incomplete. RJFJR (talk) 14:54, 21 July 2010 (UTC)
Fellowships are provided at the following universities:
Duke Medical Center
Stanford University Medical Center
Alameda County Medical Center - Highland Hospital
Loma Linda University
Keck School of Medicine at the University of Southern California
George Washington University 
Emory University 
Medical College of Georgia
Rush University/ Cook County Hospital
University of Illinois at Chicago
The Johns Hopkins University
University of Maryland
Columbia University/New York Presbyterian Hospital
Long Island Jewish Medical Center
University of Rochester Medical Center
University of Pittsburgh
Vanderbilt University
Rhode Island Hospital- Brown University

Hello, my name is Matthew, and I'm an undergraduate student from Rice University. I'm intending on expanding and rewriting this article for a class project. Currently there isn't much more than a definition and description of the International Conference on Emergency Medicine. I'd like to create more of a focus on the establishment/improvement of emergency medicine in developing countries. There is actually a fairly extensive literature on international emergency medicine in some of the emergency medicine journals so there is a lot of scope to add information about the state of emergency medicine in the developing world and initiatives that are underway to improve it. I'm still trying to figure out how to strike a balance between a broad overview of the topic and examples from specific countries.  My plan is reorganize what is already there and to create sections like "Overview of international emergency medicine", "Institutions involved", "Role in the overall health system", "Initiatives to expand emergency medicine", and "Challenges." I would be glad to hear if anyone had ideas on other sources I could use as most of my intended sources are from medical journals. Any suggestions for the best way to go about this project?   Mjs15 (talk) 15:45, 3 October 2012 (UTC)

Welcome. Toil away. If you have any queries on anything, ask at WT:MED, where you introduced yourself earlier. I know a bit about the editing policies so feel free to ask anything on my talk page. --Anthonyhcole (talk) 15:52, 3 October 2012 (UTC)

Hi, nice work on a complicated topic. I think the article, ironically, needs a little bit more 'global perspective'. A basic example to illustrate what I mean is the reference to "practicing abroad", which means different things depending on where you are. Similar problem with "emergency medicine in other countries" being a key part of the definition. Other than what? Is "international medicine" actually, specifically, the practice First world emergency medicine in Third World countries? I don't like these terms, but to be honest I prefer them to developed/developing, which IMO are actually more loaded. 
Are there cultural practices outside of the global capitalist monoculture that could be considered "emergency medicine"? If so, are these part of "international emergency medicine" when they are used in, for example, the United States? Or is "international emergency medicine" a unidirectional transfer from Us to Them? (With Anglo-American and Franco-German the only choices. Which actually makes me wonder, even within the first world, about the state of Soviet international emergency medicine...)
None of which is to trash your hard work or even suggest we need to remove anything, but I do think some expansion and reframing is necessary. Salaam, groupuscule (talk) 19:40, 26 October 2012 (UTC)

Thanks for the c/e and feedback. This is just my first draft of the article, so I'll try to address some of your concerns when I go back to rewrite and expand it. 
I see what you mean about trying to write from a more global perspective and I'll try to incorporate that into my edits. However, I think that developing and developed are probably the clearest terms for discussing countries in international emergency medicine, as well as being the ones used in the literature. Of course, they are not ideal either, especially as some otherwise fairly developed countries lacked emergency medical systems until recently. I'll give the issue some more thought.
I don't know much about "cultural practices outside of the global capitalist monoculture" but international emergency medicine is certainly about more than just transfers from us to them. Research and best practices should flow both ways. I'll try to emphasize that more in my edits.    Mjs15 (talk) 01:03, 28 October 2012 (UTC)

Hi Matt! I think this article is a really good and well-written. I have a few suggestions which you can feel free to take or ignore. I think under the importance section the final sentence in the third paragraph needs to either be rephrased or cited so that it won't be perceived as a factual claim without any proof. Also, I think in general it would be good to be cognizant of the fact that this is an encyclopedic entry so the language needs to be neutral. So one sentence in particular that I think needs to be rewritten or cited is under the importance section also and it says "Emergency departments are excellent locations to train health care providers and to collect data due to the density of patients". Also, some of the transitions seem a little too colloquial for an encyclopedic article such as of course and as would be expected so I think it'd be helpful if you changed that. Best, Lgriffin92 (talk) 02:46, 30 November 2012 (UTC)

This review is transcluded from Talk:International emergency medicine/GA1. The edit link for this section can be used to add comments to the review.
Reviewer: Sasata (talk · contribs) 20:53, 17 January 2013 (UTC)
I'll take this on, but before I post a review, I'd like some assurance that there will be someone willing to work on this (the student who submitted for GAN has not edited since December 10). Access to the sources used in the article will be essential. Any takers? Sasata (talk) 20:53, 17 January 2013 (UTC)
I'm still around. As a college student I tend to be fairly busy but just let me know what you need and I'll see what I can do. Thanks. Mjs15 (talk) 01:39, 18 January 2013 (UTC)

Very good; I'll post a review later this week. Sasata (talk) 23:37, 21 January 2013 (UTC)

There hasn't been any activity on this page since I posted the above review on Jan 27, and few substantial edits to the article itself. I'm going to remove this from the GAN queue now; any interested editors are welcome to use the above suggestions to improve the article. Sasata (talk) 23:19, 14 February 2013 (UTC)
I'm working my way through the edits slowly. I'll renominate the article once I get around to fixing all of your concerns. Thanks for posting your review. Mjs15 (talk) 05:00, 15 February 2013 (UTC)

I'll take on the changes recommended in the GA review. Seeing as the article wasn't promoted at that time and is not currently under review, I can get this article up to GA status at my own pace. AmericanLemming (talk) 21:35, 17 June 2013 (UTC)

These are the things that I'll be changing. AmericanLemming (talk) 22:21, 17 June 2013 (UTC)

This review is transcluded from Talk:International emergency medicine/GA2. The edit link for this section can be used to add comments to the review.
Reviewer: Cryptic C62 (talk · contribs) 16:29, 12 July 2013 (UTC)
My overall impression: The research and sourcing in this article is top-notch, and it is clear that a lot of work has been put into it. However, the quality of prose leaves much to be desired, and there are some organizational issues that need to be addressed. Finally, I see some minor problems in the footnotes, but we can look at that later.

Organization

Prose comments

Footnotes

As sort of a random question, how much work would I be looking at if I wanted to get the article to Featured Article status? AmericanLemming (talk) 04:05, 31 July 2013 (UTC)

The best way to answer that question would be for you to just go ahead and nominate the article at WP:FAC. The article is definitely good enough that, at the very least, you'll get some useful feedback; it certainly won't be quickfailed. --Cryptic C62 · Talk 00:42, 5 August 2013 (UTC)

I'm not an expert on FA, so take all my comments below with a grain of salt. I've tried to be picky to give you as much as possible to work with. I also made some changes as I went, which you should feel free to revert any (or even all) of. 
My first impression is that this looks quite good, and I'm very grateful for your work on it. This was a topic that I wasn't familiar with, and I learned a lot reading this article. The difference between Anglo and Franco health care models was particularly interesting.
The biggest issue for me (as you'll gather from my comments below, made as I went) is that I felt much of the analysis this article presents should be more directly attributed in-text; many statements that seemed to verge on opinion or interpretation are presented in Wikipedia's voice as established fact. None seemed terribly egregious, but it wouldn't be a hard issue to fix; just change more of the prose to "Weiner et al. state that a key factor in international emergency medicine", etc.
A secondary issue was that I was unclear what debates or controversies might exist in this specialty. (There's the debate over the definition, but I found it difficult to understand what the second group of authors saw as oxymoronic, or what their disagreement meant in practical terms.) Some discussion clarifying different approaches/schools of thought, and critiques of those approaches, would be useful, if this exists.
I hope some of this is helpful! Thanks again for your work on this one, it's really terrific how far you've brought it. -- Khazar2 (talk) 02:56, 19 August 2013 (UTC)


### Comments
"However, this definition has been criticized as oxymoronic, given the international nature of medicine and the number of physicians working internationally." -- wouldn't this make it redundant, rather than an oxymoron? I'm not sure I follow this part.
Truth be told, I'm not exactly sure either. I didn't write that sentence. MJs15 did. But, seeing as he is somewhat occupied at the moment, take a look at the relevant paragraph from the source in question at the bottom of the talk page. AmericanLemming (talk) 06:59, 20 August 2013 (UTC)
"although these countries' EMSs did not become fully mature until the early 1990s" -- this seems like an opinion that might be attributed to someone. It seems likely that the field will continue to develop in both developed and developing nations, whereas this paragraph implies that some countries are finished with that process.
The relevant sentence from the source is "With maturation of EM as a specialty in these countries, a number of EM practitioners in the early 1990s started to turn their attention to developing the specialty in other countries." That same article notes that the precise years in which EM started and became mature in these countries are debatable. AmericanLemming (talk) 03:49, 20 August 2013 (UTC)
How does "improved healthcare" lead to more interest in emergency medicine?
To quote the relevant section of the source directly, "There are also a number of reasons for recent increasing interest in developing EM within other countries. These include the general overall medical system improvement in most countries." As the quality of healthcare improves, it raises public expectations for healthcare, as the public begins to expect further improvements (Or at least that's what I'm inferring.) Also, as some aspects of a healthcare system are "brought up to speed," it makes both policy-makers and the public more aware of other aspects that need to improve (Again, I'm reading between the lines.) As a disclaimer, none of my explanation here is directly supported by the source. AmericanLemming (talk) 06:36, 20 August 2013 (UTC)
I feel that the lead may be more detailed than necessary. For example, I was surprised that the discussion of whether the definition is oxymoronic rests entirely on a three-page article; perhaps there's just very little written about this topic, but that seems like a minor blip to make it into the lead.
Well, the FA reviewer thought that the lead was way too short and didn't cover everything in the article, so I greatly expanded it. I stand by the lead as a whole, but it is true that the alternative view mentioned in the lead is a minority view. I guess it's a question of whether it's significant enough to be mentioned. On one hand, we want to avoid giving undue weight, but on the other hand, we don't want to imply that everyone is in agreement on the definition. AmericanLemming (talk) 02:01, 20 August 2013 (UTC)
I wonder if it would be possible to just write something like "but this definition has also been criticized"? Perhaps you're right that it's better to have detail, though. -- Khazar2 (talk) 02:13, 20 August 2013 (UTC)
" "increased public expectations...in many countries."" -- this seems like a quote that could simply be paraphrased; the exact wording doesn't seem terribly important
 Done AmericanLemming (talk) 02:09, 20 August 2013 (UTC)
" thus showing a need to improve emergency medical care" -- I'd suggest attributing this analysis to its author in-text as well as in the citation.
 Done AmericanLemming (talk) 02:11, 20 August 2013 (UTC)
As a broad note, I feel like the article includes many statements that seem to me borderline on whether they need in-text attribution. "Emergency departments are excellent locations to train health care providers and to collect data, because of the high number of patients" seems like a bit of opinion that shouldn't be in Wikipedia's voice; I wouldn't flag an individual statement like that, necessarily, but it seems to happen often.
 Done I've attributed that entire paragraph to the authors of the source. As far as the article in general goes, if you think it would benefit from more such attribution, I'll put it in there, but that would take a while. AmericanLemming (talk) 07:12, 20 August 2013 (UTC)
"which relies on "bringing the patient to the hospital", and the Franco-German model, which operates through "bringing the hospital to the patient."" -- these quotations should be followed by an inline citation
 Done AmericanLemming (talk) 02:15, 20 August 2013 (UTC)
"Within that understanding of emergency care models there is also an acknowledgement that current Western models may be totally inadequate in the context of developing nations." -- By "that understanding", do you mean Arnold and Holliman?
 Done Yes. I have clarified that point. However, in the interest of full disclosure, ref 10 does not warn against Western models in general; it merely advises against adopting all aspects of the United States' EMS model, as some of those are nor suited to developing countries. AmericanLemming (talk) 06:47, 20 August 2013 (UTC)
"that current Western models may be totally inadequate in the context of developing nations" -- it seems like the Kuala Lumpur example demonstrates that Western models would not be cost-effective, but I'm not sure that's the same as "totally inadequate", which suggests to me a failure to provide care
 Done I'm glad you pointed that out. I didn't realize that it could be confusing to some people. AmericanLemming (talk) 02:18, 20 August 2013 (UTC)
"In developed counties, international emergency medicine is one among many initiatives underway to shape the future of emergency medicine. " -- this phrasing seems like ad-speak--does it mean anything besides "international emergency medicine exists"?
 Done It does not. I have removed the sentence. One subtle bias this article may have is its attitude toward EM and EMS; the editor who wrote most of it, Mjs15, is an EMT. AmericanLemming (talk) 04:04, 20 August 2013 (UTC)
"Such exchanges can be mutually beneficial. For instance, 23 to 28 percent of all physicians in Australia, the United States, the United Kingdom and Canada received their training at medical schools outside of the country in which they currently practice" -- does the source describe this as mutually beneficial? The article is titled "brain drain".
It does not. I think the idea is that while developing countries can benefit from short-term trips by physicians from developed countries, developed countries greatly benefit from physicians from developing countries who move there permanently. Obviously, developed countries benefit much more from this exchange than developing ones do, but I'm not sure if I can say that in the article without a ref to back me up. AmericanLemming (talk) 03:09, 20 August 2013 (UTC)
"Some money may be available from wealthier nations or international organizations, but careful decisions still need to be made" -- another moment where this seems to me to veer into analysis
 Done I've removed the analysis, as I'm pretty sure the guy who added that sentence just put it in there, without a source to back him up. (Mjs15, the editor who expanded the article from a stub to a C- or B-class article, is my brother. He doesn't understand all of Wikipedia's nuances.) Also, I don't think removing the sentence changes the meaning of the paragraph at all. AmericanLemming (talk) 03:37, 20 August 2013 (UTC)
"Regardless of the amount of preventive care available, health problems requiring immediate attention will still occur and emergency medical programs could increase access to care, particularly if they focus on low-cost but effective treatments administered by first responders" -- another moment that should be attributed to an author, I think. The article at times appears to be assembling an argument for the importance of this discipline.
I've attributed the second part of that sentence, but I think the first part falls under analysis/original research, however self-evident it may seem. I don't think I can find a ref for the first part, either. AmericanLemming (talk) 06:54, 20 August 2013 (UTC)
"Africa is the continent most in need of developing emergency medical systems" -- is this universally agreed? Seems like another moment that could use "According to,"
 Done I think it's pretty obvious that the caption is true, but I understand the need to give attribution and then let readers come to their own conclusions. AmericanLemming (talk) 03:43, 20 August 2013 (UTC)
"One key component in equipping nations to develop emergency medical systems is to identify the aspects of training that are essential for health care providers" -- attribute
 Done AmericanLemming (talk) 02:55, 20 August 2013 (UTC)
"a standard curriculum is still useful for identifying core issues" -- attribute
 Done AmericanLemming (talk) 02:55, 20 August 2013 (UTC)
"Scott Weiner suggests" -- should this be Scott Weiner et al.?
 Done Yes, it should be. AmericanLemming (talk) 02:32, 20 August 2013 (UTC)
"Its application worldwide could lead to the boon of sharing best practices between emergency medicine practitioners in various countries, thus advancing the current standard of emergency care." -- attribute
 Done AmericanLemming (talk) 02:36, 20 August 2013 (UTC)
"Educational opportunities in emergency medicine are not available in many countries, and even when present, they are often in their infancy" -- so if the goal of the specialty is to promote EMS knowledge and training in other countries, how is lack of training in other countries a "challenge" to that? Shouldn't it be expected that the people you plan to train are not yet trained?
I would say that this is analogous to the proverb "Give a man a fish and you feed him for a day. Teach a man to fish and you feed him for a lifetime." It's impossible for EM practitioners from developed countries to teach the relevant skills to every individual in developing countries who needs to know these things. I think the idea is that it's easier to train people in the relevant skills than it is to train people to train people in the relevant skills, hence the challenge.
In short, it's easier in the short run to train people than it is to train them to train other people, but it's more sustainable in the long run to do the latter. If you find it confusing, it may need some rewording, but I'm not entirely sure how to go about doing that. AmericanLemming (talk) 02:46, 20 August 2013 (UTC)
Relevant paragraph from source 3:
As medicine has become more global, opportunities to practice in other countries have expanded. Indeed, ‘‘international emergency medicine’’ is to some degree an oxymoron. Medicine is by definition international. Nigerian physicians working in Great Britain or Kenya are obviously working internationally. So are Dutch physicians working in the Netherlands after training in the United States. Indeed, some of us have become transnational. This raises a definitional problem: if IEM is defined only as ‘‘... the area of emergency medicine concerned with the development of emergency medicine in other countries," this will have limited applica- bility to most international jobs.


### Controversies
I do have a source that would seem to lists some controversies about IEM: Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations. 
On a separate note, I am starting to think that the article isn't comprehensive enough for FA status. It doesn't mention international pediatric emergency medicine at all (a 
sub-subspecialty of EM), growth in the number of EM journals around the world; or any controversies about IEM. I probably should withdraw it from the FAN list, as I really don't have time to fix any of those gaps, either. AmericanLemming (talk) 07:35, 20 August 2013 (UTC)

I'm hesitant to try to judge as a non-expert, but from what you say those do sound like areas that should be included. Perhaps you should pull and try to fill those gaps, and then go for a peer review before taking this to FA again? I think you've done a good job addressing my concerns above, so I'm not sure I can make any further suggestions myself, but PR is a stop for many editors pre-FA; hopefully you could get some good further feedback there. In either case, though, I wish you the best of luck with this important topic! -- Khazar2 (talk) 00:25, 23 August 2013 (UTC)

Hello fellow Wikipedians,
I have just modified one external link on International emergency medicine. Please take a moment to review my edit. If you have any questions, or need the bot to ignore the links, or the page altogether, please visit this simple FaQ for additional information. I made the following changes:

Added archive https://web.archive.org/web/20130920141110/http://ifem.cc/IFEM_Conferences_and_Symposia/International_Conference_on_Emergency_Medicine.aspx to http://www.ifem.cc/IFEM_Conferences_and_Symposia/International_Conference_on_Emergency_Medicine.aspx
When you have finished reviewing my changes, you may follow the instructions on the template below to fix any issues with the URLs.
This message was posted before February 2018. After February 2018, "External links modified" talk page sections are no longer generated or monitored by InternetArchiveBot. No special action is required regarding these talk page notices, other than regular verification using the archive tool instructions below. Editors have permission to delete these "External links modified" talk page sections if they want to de-clutter talk pages, but see the RfC before doing mass systematic removals. This message is updated dynamically through the template {{source check}} (last update: 5 June 2024).

If you have discovered URLs which were erroneously considered dead by the bot, you can report them with this tool.
If you found an error with any archives or the URLs themselves, you can fix them with this tool.
Cheers.—InternetArchiveBot (Report bug) 10:11, 15 November 2017 (UTC)

 This article is the subject of an educational assignment at Rice University supported by  the Wikipedia Ambassador Program during the 2012 Q4 term. Further details are available on the course page. 
The above message was substituted from {{WAP assignment}} by PrimeBOT (talk) on 16:17, 2 January 2023 (UTC)