Disaster Fellowship

Harvard Affiliated Disaster Medicine Fellowship Program

Fellowship Curriculum

2009-2010

Division of Disaster Medicine

Beth Israel Deaconess Medical Center

Disaster Medicine Section

Harvard Medical School

Program Director:

Gregory R. Ciottone, MD, FACEP

Assistant Professor of Medicine

Chair, Disaster Medicine Section

Harvard Medical School

One Deaconess Road

Boston, MA 02215

Office: (617) 667-1701

Faculty:

Paul Biddinger MD

Amado Alejandro Báez MD

Jonathan Burstein MD

David Callaway MD

Ted Curcio MD

Meg Femino

Robert Lipton, Ph.D.

Robert Macy, Ph.D.

Assaad Sayah, MD

Debra Weiner, MD

Richard Zane MD

Program Duration:

Twelve months

Eligibility:

Applicants must have completed a recognized Emergency Medicine residency program or equivalent.

Funding:

Currently, the fellowship is only available for Self-funded applicants.

Program Description:

The DM fellowship program is designed to provide qualified emergency physicians the opportunity to develop an expertise in the related fields of Disaster Medicine (DM) and Emergency Management (EM). This is accomplished through didactic lectures, seminars, and readings, goal-related research in a specific area of DM and EM, and fieldwork resulting in a thesis. Upon completion of this fellowship, fellows will be skilled in all aspects of the disaster cycle and have the ability to assume a leadership role on the local, regional, federal, or international level in the area of Disaster Medicine and Emergency Management. It is assumed that after graduation fellows will assume such a leadership position and be active in research and academics, leading to becoming an internationally noted expert in these fields.

Program Objectives:

The program will help fellows achieve the following:

· Develop a knowledge base and skills set to be experts in all phases of the disaster cycle.

· Participation in local, regional, federal, and international DM activities.

· Develop a comprehensive knowledge base of United States’ Preparedness and Response System.

· Develop skills to take leadership roles in their community

· Develop a compentency in DM research and teaching skills.

Training Structure:

The fellow will be invovled in the following basic areas of training: didactic lectures and readings, participation in hospital-based, local, and regional leadership committees, research, fieldwork, and thesis development.

1. Didactic Education:

The didactic component of the training occurs throughout the duration of the fellowship and consists of textbook readings, small group lessons, courses and lecture series.The fellow will also be asked to give two presentations to the Emergency Medicine residents at Beth Israel Deaconess Medical Center (BIDMC) Residency Program during his/her fellowship.

2. Committee participation:

Throughout the fellowship the fellow will participate in both BIDMC and Boston disaster-related committees/activities, including the BIDMC Emergency Management Committee, The Longwood Medical Area Emergency Management Committee, Center for Public Health Preparedness at Harvard School of Public Health, the Conference of Boston Teaching Hospitals (COBTH) Medical Academic and Scientific Community Organization (MASCO) and the Boston Metropolitan Medical Response System

3. Research:

The research and thesis development portion of the training will span the entire fellowship period. The fellow will be asked early on to define a research goal and to begin designing his thesis. The research and subsequent thesis will focus on a specific area of Disaster Medicine or Emergency Management and will be approved by the Fellowship Director. The goal of the thesis is for it to be published in the specialty literature.

3. Fieldwork:

The fieldwork phase will be in 2 parts. The fellow will perform fieldwork either within the United States, through the National Disaster Medical System/ Disaster Medical Assistance Teams (DMAT) (arranged by the fellowship), or his/her country of origin. A six-week rotation at the Centers for Disease Control and Prevention (CDC) is included in the Fellowship program (Appendix A). This fieldwork will be overseen by the Fellowship Director and must lead to a thesis. At the start of the Fellowship, the fellow will present his concept for a thesis and it must be accepted by the Fellowship Director prior to the start of the fieldwork period.

Core Knowleadge:

The fellowship will focus on the following areas:

A. Introduction to Disaster Medicine and Emergency Management:

a. Common Definitions and Disaster Cycle

b. Role of hospitals, EMS and public health in Disasters

c. Psychological Impact of Disasters

d. “All Hazards” Emergency Operation Plans in healthcare facilities

e. Conducting a Hazard Vulnerability Analysis

f. Training and programs evaluations

g. Overview of govermental resources

B. Medical management in specific events:

a. Natural Disasters

b. Blasts/collapse/shooting/crashes/terrorism

c. Chemical/HazMat events

d. Biological events (Bacterial/Viral/Toxin disease recognition, infection control, vaccination, prophylaxis etc)

e. Nuclear/Radiological events

C. Operational principles:

a. Incident Command System

b. Mass Casualty Triage and response

c. Surveillance

d. Communications

e. Search and Rescue

f. Decontamination and Personal Protective Equipements (PPE)

g. Evacuation

h. Surge Capacity

i. Media

j. Legal and ethical issues in Disasters

k. Integration of prehospital, hospital and public health services

Recommended Readings:

a. Disaster Medicine. 1st ed. Ciottone GR (ed). Philadelphia: Mosby Elsevier, Philadelphia, 2006.

b. Disaster Medicine. David E. Hogan and Jonathan L. Burstein. Lippincott Williams & Wilkins; Second Edition edition (March 1, 2007)

c. Advanced Disaster Medical Response Manual for Providers. Susan Briggs and Kathryn H. Brinsfield Harvard Medical International; 1st edition (July 2003)

Courses:

a. Incident Command System (100, 200, 300, 400, 700, 800)

b. Hospital Incident Command System (HICS)

c. Basic/ Advanced Disaster Life Support (BDLS/ADLS)

d. Hazardous Material Training (Level B and C)

e. Homeland Security Exercise and Evaluation Program (HSEEP)

f. Courses offered at DelValle Institute for Emergency Preparedness

g. Courses offered by Massachusetts Emergency Management Agency (MEMA)

h. Other online courses offered through FEMA website

Recommended Conference Attendance:

a. Annual Integrated Medical, Public Health, Preparedness and Response Training Summit (NDMS)

b. World Congress on Disaster and Emergency Medicine

c. American College of Emergency Physicians (ACEP) Scientific Assembly

Evaluation:

A. Fellow Evaluation:

The fellow will have ongoing contact with the fellowship director and faculty. He /she will be evaluated formally at the midpoint and at the end of the fellowship period. Evaluations will consist of assessment of thesis and research progress and ongoing assessment of knowledge base. Multiple evaluators will be used (e.g., faculty, peers,

self, and other professional staff). Successful completion of the fellowship will be accomplished by achieving unanimous approval of the faculty and fellowship director and passing grade on the thesis.

B. Faculty Evaluation

At least once a year, the program will evaluate faculty performance including a review of the faculty’s teaching abilities, commitment to the fellowship program, DM knowledge, professionalism, and scholarly activities.

C. Thesis Evaluation

The Fellow will write a thesis during the course of the 12 month Fellowship. The thesis will be based on an accepted subject and data will be collected during the fieldwork portion of the program. The thesis will be evaluated based on originality of subject, data collection and analysis, writing, and impact on current Disaster Medicine theories and practices. It is expected but not required that the thesis will lead to a peer-reviewed journal publication.

D. Program Evaluation and Improvement

The program document formal, systematic evaluation of the curriculum at least annually. The program will monitor and track fellows and faculties’ performance. If deficiencies are found, the program will prepare a written plan of action to document initiatives to improve performance in the areas identified.

APPENDIX A

Harvard – CDC Disaster Medicine Fellowship Rotation

CDC Rotation Description:

The Disaster Medicine fellowship program at Harvard is designed to provide qualified emergency physicians the opportunity to develop an expertise in the related fields of Disaster Medicine (DM) and Emergency Management (EM). The Centers of Disease Control and Prevention (CDC) rotation will enrich this fellowship through the contribution to the didactic education, research and fieldwork experience of the fellows.

 

 

Position Title:

Disaster Medicine Fellow

Location:

Centers for Disease Control and Prevention

Atlanta, GA

Duration:

2 months

Description of Responsibilities:

Harvard Disaster Medicine Fellows are board-certified (or eligible) emergency physicians with some prior experience in DM, EM or public health. During their fellowship, they seek to gain experience in actual disaster management with governmental and non-governmental organizations.

The CDC is seeking a fellow to become an integral member of the team. Working closely with senior staff, the fellow will gain significant experience through involvement in international public health emergency preparedness and response programs. The fellow will gain strategic experience through assignment of a specific program for development.

Daily duties include, but are not limited to:

· Research and analysis of issues related to public health emergency operations planning and exercises.

· Assist in communication and outreach to build strategic partnerships amongst federal and international agencies.

• Assist in the development and application of public health risk reduction measures in multiple nations.
• Participate in the teaching activities offered by CDC
• Participate in CDC-led research and development projects

Harvard – CDC Disaster Fellowship Rotation Schedule

Rotation #1 October 1 - December 31, 2009

 

Pre-event preparation:

The fellow will contact Rufus Reddick (rfr2@cdc.gov) before September 1, 2009 to begin the process for matriculation.

Start of fellowship rotation:

The fellow should present to Dr. Mark Keim’s office at CDC Chamblee campus Building

106, room 02035 at 08:00 on Monday, October 5, 2009. (See map and instructions)

Week #1: Documentation and Orientation (October 5-9)

The fellow will obtain the following:

1. Basic security clearance and procurement of identification badge

2. Assignment of their workspace and computer access

3. An orientation to our office

4. Participation in one office and one team staff meeting

5. Work assignment for fellow presentation on the public health

consequences of a specific disaster hazard of their choice

Week #2: Office of the Surgeon General, Medical Reserve Corps (MRC)

Public Health Emergency Management Course (PHEMC) (October 12-16)

The fellow will participate in the following activities:

1. Attend the 3 day MRC PHEMC as taught by CDC

2. Location: Bethesda, MD (Harvard to pay travel)

Week #3: CDC Study Tour (October 19-23)

The fellow will participate in the following activities:

1. Study Tour of CDC emergency preparedness response organizations.

This will include on-site visits to CDC biological and chemical

laboratories, as well as the CDC emergency operations center. It will also include lectures by key CDC subject matter experts that provide an overview of their office activities.

2. This study tour will also be attended by a delegation from the

China Ministry of Public Health. The fellow will be encouraged to

participate actively with this group

3. Participation in one office and one team staff meeting

Weeks #4 - 5: Project preparation and lecture presentation (Oct 26 – Nov 6)

The fellow will participate in the following activities:

1. Assist CDC in preparation of training materials for Shanghai, China World

Exposition Table Top Exercise

2. Prepare fellow presentation on the public health consequences of

a specific disaster hazard of their choice

3. Participation in two office and two team staff meetings

Week #6 - 7: 2010 World Expo Public Health Tabletop Exercise - Shanghai, China

(November 9-20)

The fellow will participate in the following activities:

1. Assist CDC to teach, facilitate development and oversee the implementation of a

tabletop exercise hosted by Shanghai public health leadership

2. Harvard to cover travel expenses

Week #8: HOLIDAY (November 23-27)

Week #9: Project preparation and lecture presentation

(November 30 – December 4)

The fellow will participate in the following activities:

1. Assist CDC in preparation of training materials for Shanghai, China World

Exposition Operational Exercise

2. Prepare fellow presentation on the public health consequences of

a specific disaster hazard of their choice

3. Participation in one office and one team staff meeting

Week #10: 2010 World Expo Public Health Operational Exercise - Shanghai, China

(December 7-11)

The fellow will participate in the following activities:

1. Assist CDC to teach and facilitate development of an operational exercise hosted

by Shanghai public health leadership

2. Harvard to cover travel expenses

Week #11 Rotation closing (December 14-18)

The fellow will participate in the following activities:

1. Evaluation of the rotation

2. Participation in one office and one team staff meeting

3. Deliver fellow presentation on the public health consequences of

a specific disaster hazard of their choice

Week #12 HOLIDAY (December 21-31)

Rotation #2 –January 1 – March 31, 2010

 

Pre-event preparation:

The fellow will contact Rufus Reddick (rfr2@cdc.gov) before December 1, 2009 to begin the process for matriculation.

The fellow would present to Dr. Mark Keim’s office at CDC Chamblee campus Building

106, room 02035 at 08:00 on Monday, January 4, 2010. (See map and instructions)

Week #1: Documentation and Orientation (January 4-8)

The fellow will obtain the following:

1. Basic security clearance and procurement of identification badge

2. Assignment of their workspace and computer access

3. An orientation to our office

4. Participation in one office and one team staff meeting

5. Work assignment for fellow presentation on the public health

consequences of a specific disaster hazard of their choice

Week #2: 2010 World Expo Public Health Operational Exercise - Shanghai, China

(January 11-15)

The fellow will participate in the following activities:

1. Assist CDC to facilitate the implementation of an operational exercise hosted by

Shanghai public health leadership

2. Assist CDC to facilitate an After Action Review of the exercise

3. Assist CDC to facilitate revision of the Shanghai CDC emergency operations plan

4. Harvard to cover travel expenses

Week #3: CDC Study Tour (January 18 -22)

The fellow will participate in the following activities:

1. Study Tour of CDC emergency preparedness response organizations.

This will include on-site visits to CDC biological and chemical

laboratories, as well as the CDC emergency operations center. It will also include lectures by key CDC subject matter experts that provide an overview of their office activities.

2. Attend Dr. Keim's two-hour course at Emory University Rollins

School of Public Health on "National Security and Disasters"

3. Participation in one office and one team staff meeting

Weeks #4-5: Project preparation and lecture presentation (January 25 – February 5)

The fellow will participate in the following activities:

1. Assist CDC in preparation of training materials for Guatemala CDC

Public Health Emergency Management course

2. Attend Dr. Keim's two-hour course at Emory University Rollins

School of Public Health on "National Security and Disasters"

3. Prepare fellow presentation on the public health consequences of

a specific disaster hazard of their choice

4. Participation in two office and two team staff meetings

Week #6: Guatemala Regional CDC Office, Public Health Emergency Management Course (February 8-12)

The fellow will participate in the following activities:

3. Attend the 3 day course as taught by CDC

4. Location: Guatemala (Harvard to pay travel)

Weeks #7-8: Project preparation and lecture presentation (February 15–26)

The fellow will participate in the following activities:

1. Assist CDC in preparation of training materials for Medical Reserve Corps

Public Health Emergency Management course

2. Attend Dr. Keim's two-hour course at Emory University Rollins

School of Public Health on "National Security and Disasters"

3. Prepare fellow presentation on the public health consequences of

a specific disaster hazard of their choice

4. Participation in two office and two team staff meetings

Week #9: Office of the Surgeon General, Medical Reserve Corps (MRC)

Public Health Emergency Management Course (PHEMC) (March 1-5)

The fellow will participate in the following activities:

1. Attend the 3 day MRC PHEMC as taught by CDC

2. Location: Bethesda, MD (Harvard to pay travel)

Week #10 Rotation closing (March 8-12)

The fellow will participate in the following activities:

1. Evaluation of the rotation

2. Attend Dr. Keim's two-hour course at Emory University Rollins

School of Public Health on "National Security and Disasters"

3. Participation in one office and one team staff meeting

4. Deliver fellow presentation on the public health consequences of

a specific disaster hazard of their choice

Weeks #-11-12 HOLIDAY (March 15-31)

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