A cross-sectional study assessing the emergency medicine knowledge of final-year interns in the Eastern Cape, South Africa

Emergency Medicine (EM) is a nascent, but rapidly growing speciality within South Africa, encompassed by worldwide recognition of the need for improved emergency care. Although EM physicians increasing lead many larger South African Emergency Departments, the initial provision of emergent care often occurs at facilities manned by junior, non-specialist doctors, early in their career. Newly qualified doctors complete a 2-year internship phase, during which their exposure and training in EM is not standardised. Limited data regarding the impact of EM on foundation year training exists in South Africa. Therefore, a need exists to identify EM knowledge gaps at the end of internship, to direct future EM training.

A cross-sectional study utilising an EM assessment tool previously developed via a modified Delphi study by the authors was performed. During 2022-2023, final-year interns in two cities in the Eastern Cape of South Africa were invited to participate in the assessment tool and complete a short survey on self-perceived knowledge and readiness to manage emergent conditions in their community service year.

A total of 146 interns from two sites participated in the study (representing undergraduate training from all South African medical schools). Participants scored poorly on questions regarding the assessment of acute cardiac events and resuscitation of acutely ill patients and scored highest in questions on obstetric emergencies and management of urgent, rather than emergent conditions. Interns emphasised the need for longer exposure time in EM, and the need for structured and standardised training, including the use of simulations, case-based discussions and practical skills training.

To improve the quality of emergency care in the South African public healthcare system, EM training and exposure at the internship level should be prioritised. Recommendations include instituting structured and standardised EM training within a supervised environment and further research on intern readiness to manage emergent medical conditions.