In this issue:

  New partnership will expand medical education projects in Croatia

Emergency medicine program will support specialty training in Italy

  Hospital strategies are a focus for Korean leaders during visit to Boston

  Conference shows students opportunities in international health

  Pediatric intensive care conference will take a global perspective

New partnership will expand medical education projects in Croatia
An agreement between HMI and the University of Zagreb Medical School (UZMS) was signed Jan. 16 for the first year of a long-term collaboration designed to advance medical education in Croatia. The partners have previously worked together on workshops in curricula development and courses in tutor training and case-based teaching. This new agreement will broaden the relationship to include on-site faculty development workshops and strategic planning for UZMS medical curricula. Through the partnership, two UZMS physicians will also participate in the Harvard Macy Program for Physician Educators in Boston, and the faculty will receive mentorship throughout the year to work on an educational project. The agreement was signed as part of a celebration for the 85th anniversary of the medical school. The event was attended by several leaders of the Croatian government and in medicine, including the country’s vice president, who see the program as a first step toward widespread changes in health care.

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Emergency medicine program will support specialty training in Italy

Left to right: Dr. Sharon Kleefield, HMI director; Giovanni Becattini, assistant chief nurse in the emergency department of Careggi Medical Center; and Dr. Philip Anderson, Harvard Medical School instructor in medicine at BIDMCED, tour Careggi Hospital

HMI is involved in a project to develop a new model of emergency medical care in the Tuscany region of Italy. The Beth Israel Deaconess Medical Center Emergency Department (BIDMCED) invited HMI to take part in a project developing emergency medicine systems at Careggi Hospital in Florence, Italy, as part of a project that was launched by the Ministry of Health of Tuscany and the University of Florence Hospital. The intent of the project is to develop an Emergency Medicine Center of Excellence at Careggi Hospital and to use this center to certify Tuscan physicians working in emergency departments throughout the region of Tuscany.

Emergency medicine is not always recognized as a distinct specialty in many parts of the world. The ultimate goal is to improve patient care by creating a specialized role for emergency department physicians and design new systems that will support this specialization. BIDMCED will provide a residency training program for physicians at Careggi Hospital, and will help set up a residency training program modeled after U.S. systems in Florence. HMI will be providing expertise in faculty development programs, the design of case study courses, assessment methodologies for training of physicians, and standards and measure of clinical quality.

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Hospital strategies are a focus for Korean leaders during visit to Boston
Two leaders from HMI’s longstanding partner Asan Medical Center (AMC) visited HMI in early January to confer about aspects of hospital management and discuss this summer’s upcoming joint symposium. Dr. Changgi D. Hong, president of Asan Healthcare System, and Dr. Seong-Wook Park, director, Office of Planning and Management at AMC, spent two days with HMI representatives and met with faculty who will participate in the symposium. The event, planned for June 17 and 18 in Seoul, will focus on nanotechnology and its applications in biology and medicine.

The Asan team also came to share information and ideas on some of the areas of hospital management they would like to address in the near future. Hong said that AMC’s “top priority is keeping our stance in the Korean health care system as a forerunner in terms of quality of care, education, and research.”

Dr. Seong-Wook Park, left, and Dr. Changgi D. Hong visit HMI’s offices in Boston

Hong said that consumer expectations in Korea are growing, and there are concerns that this will lead to more lawsuits and higher jury awards similar to the U.S. situation, and with it a greater malpractice insurance burden for Korean physicians and hospitals. As part of the visit, Hong and Park consulted with representatives from the Risk Management Foundation of the Harvard Medical Institutions to learn about strategies of loss prevention.

Hong said that AMC also hopes to continue work in quality management systems. “We started this a few years ago and already have accumulated enough baseline data to measure outcomes and processes of clinical care,” he said. Nursing is also a priority. “We have a shortage of experienced nurses,” said Hong, and turnover is high in the field in Seoul as in many parts of the world (see this issue’s Forum). Nurses from AMC have visited Harvard-affiliated hospitals through the partnership, where they are able to examine the more flexible management styles of U.S. hospitals as well as study protocols for clinical care. “What they knew before from textbook learning is confirmed in the field,” Hong said.

AMC, an affiliate of the University of Ulsan College of Medicine and the largest hospital in Korea, has worked with HMI since 1996 and in 2000 agreed to extend the relationship in perpetuity. Hong said that Asan has found HMI’s input pertinent because “in general, Korea is repeating the picture of U.S. health care with a lag time of ten to fifteen years.” He added that it is very useful to hear about the experience of physicians in the U.S. and “use that experience as a baseline” to devise solutions adapted to the Korean situation.

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Conference shows students opportunities in international health
HMI co-hosted a conference for Massachusetts medical students interested in international health, with the Global Medicine Committee of the Massachusetts Medical Society and other New England medical schools. The conference took place Feb. 8 in Waltham, Massachusetts. Around 120 medical students from all the medical schools in New England attended talks and workshops that discussed ways to get involved in international health and research. A keynote speech by Dr. Paul Farmer, the Maude and Lillian Presley professor of social medicine at Harvard Medical School, addressed some of the challenges in treating infectious disease in developing countries.

In seven breakout workshops, physicians shared their experiences working abroad and discussed issues such as HIV care, community health, and the logistics of conducting a research project and working overseas. A panel discussion allowed students who have participated in international health projects to relay their experiences. Attending students also had the chance to network with physicians working in different countries. HMI will be serving as a permanent host of the yearly event, called the New England Regional International Health Medical Education Consortium Medical Student Conference.

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Pediatric intensive care conference will take a global perspective
The World Federation of Pediatric and Intensive Critical Care Societies (WFPICCS) is accepting registrants to the fourth World Congress on Pediatric Intensive Care hosted by Children’s Hospital of Boston and presented in conjunction with HMI in Boston, June 8-12, 2003. A large international faculty will gather at the Congress to present on current topics in all aspects of pediatric critical care medicine. The scientific program is diverse, yet it integrates all specialists in pediatric intensive care medicine and maintains a global perspective. Harvard Medical School designates this educational activity for a maximum of 22 hours in category 1 credit towards the AMA Physician's Recognition Award. Please visit http://www.PIC2003.com for registration and further information.

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