Dr. Sanniya Khan- Pakistan’s first Emergency Specialist

Dr. Sanniya Khan- Pakistan’s first Emergency Specialist

Recently, Dr. Sanniya Khan became the first Pakistani doctor to receive the highest ‘Fellowship of the Royal College of Emergency Medicine from the United Kingdom in the field of emergency while completing her training in Pakistan.

Today we have the honor to host her on our show. let’s see what she has to say.

Rohail Amjad: Assalam o alaikum and thanks for being on the show. You got your qualification from the UK (online) being in Pakistan doesn’t emergency medicine require you to be present at the hospital for any kind of training?

Dr. Sanniya Khan: Pleasure being on your show and yes Thank you for bringing this up. I would like to clarify that it is not an online degree. Fellowship of Royal College of Emergency Medicine comprises of 7 exams in total including two performance-based clinical exams where you interact with patients, perform procedures and resuscitations, and are assessed by the Royal College faculty in real-time. The clinical exam is held in the UK only and I had to travel to take these exams. You have to compete with doctors who are trained in the UK, Ireland, and other parts of the world, and prove your mettle to get this fellowship. My achievement is that I was successful in all components of the exam while completing my training in Pakistan.

The pre-requisite of taking the Fellowship exam is to have a clinical experience of 7 years including three years of emergency department experience where you have worked at a senior level. This exam can only be done after adequate training in emergency medicine.

Rohail Amjad: As it is not an online qualification, how difficult was it for you to manage study?

Dr. Sanniya Khan: It is difficult to manage studies as well as working in a shift schedule as it does impair your quality of life. Emergency shifts are 12 hours long and can be very busy as the doors of an emergency department are always open. There could be a major accident and you have to deal with 10-20 patients at the same time without compromising the care of the already admitted critical patients in ER. It is stressful, it is chaotic, it is very dynamic as it changes from shift to shift, it can cause burnout as you see deaths every day, but it is a rewarding specialty as every life saved is something to cherish. Whatever time I had during my shifts, I used to review the cases that I had seen and study about it.

Rohail Amjad: How emergency medicine is different from general medicine?

Dr. Sanniya Khan: Emergency medicine is a new field that has been recognized as a specialty in 2011 in Pakistan. It includes prehospital care- assessing patients at the spot, starting treatment immediately and continuing it during transfer, disaster medicine – dealing with large scale disasters, toxicology – dealing with poisoned patients or drug overdoses, pediatric emergency – issues specific to children, and research.

Rohail Amjad: Does emergency medicine includes dealing with surgical cases?

Dr. Sanniya Khan: Yes. Certified emergency medicine specialists can perform lifesaving surgical skills such as resuscitative thoracotomy which is a procedure to open the chest and find out the source of bleeding in a traumatic cardiac arrest, resuscitative hysterotomy- to save the life of the new born in females with cardiac arrest during later pregnancy, chest tube insertion in cases of ruptured lungs, pericardiocentesis in cases of bleeding in the heart, lateral canthotomy to save vision in case of traumatic eye injury etc. These procedures are within the domain of emergency medicine and depends on the expertise of the physician. Emergency physicians are also trained in providing procedural sedation and can deal with minor surgical procedures such as incision and drainage of abscesses, applying back slab in cases of fractures and dealing with dislocation of joints. I would like to reiterate that all these procedures depend on the expertise and resources available in the department.

Rohail Amjad: You whilst giving an interview to a foreign newspaper said that “you want to train doctors in emergency medicine in Pakistan”. Do you think there are enough resources for this?

Dr. Sanniya Khan: I think we do have the resources; it is the priority that is in question. It is the need of the time for our public and private healthcare setups to invest in emergency departments according to modern times with proper triage facilities where the sickest person is seen first, and to train their staff in latest resuscitation protocols and skills. Anyone can land in a situation where emergency services are required, and it is the local hospitals where most people will go, so its need cannot be overemphasized.

The best resource that Pakistan is abundant in, is human resource. It is one of the few countries in the world where pursuing medicine is a national aspiration. A trained emergency physician can train its own nursing staff and junior doctors in the department. With the advent of social media and online courses, I think training and educating is much easier in these times and is not highly resource dependent. Hands on skills can be developed by workshops and dedicated courses, many of which are being conducted under various emergency medicine groups in the country. My main idea is to create awareness among doctors and nursing staff that such a specialty exists and there are numerous ways to get trained in these skills.

Rohail Amjad: It’s a known fact that medical problems are controlled and surgical are cured. How far are we from getting the cure for the medical problems?

Dr. Sanniya Khan: It is a difficult question for an emergency physician to answer as in the emergency department we do not have the luxury of time to undergo extensive investigations or to make a specific diagnosis, our focus is to stabilize the patient, to make sure that we have ruled out life-threatening conditions and then hand over the care of the patient to our colleagues in other specialties for further workup and management.

Adopting a healthy lifestyle is probably the single most effective way in preventing health problems. Finding a cure is an ongoing area of research and with new evidence coming every day, we are finding better ways to deal with medical problems.

Rohail Amjad: How many emergency physicians are there in Pakistan? And what is the scope of this field in our country?

Dr. Sanniya Khan: For a population of 220 million in Pakistan, the number of emergency physicians is almost non-existent. As of last year, 2020, there are 17 locally trained emergency medicine specialists in Pakistan, around 10-15 internationally trained physicians, and a total of 150 trainees who are at various stages of their training.

In the last decade, we have witnessed numerous incidents of mass disasters, terrorism and natural calamities. The scope is vast and its importance cannot be undermined.  

Rohail Amjad: What is your advice for all those who want to pursue careers in emergency medicine?

Dr. Sanniya Khan: Emergency Medicine is a career for all those who like working in a fast-paced environment, can work under undue stress, think on the go, and have a passion to provide care when it is most needed. This is no doubt the field that helps in saving lives on the spot. This is one of the most rewarding, yet challenging fields of medicine and I would encourage young doctors to be part of this noble cause.

Rohail Amjad: thank you so much for being on the show, you are the pride of our nation, stay blessed, and Allah Hafiz

Dr. Sanniya Khan: Thank you and Allah Hafiz

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