Cooper University Health Care offers a one-year, ACGME-accredited fellowship training program to prepare physicians for the practice of emergency medical services (EMS), a clinical specialty that includes the care of patients in all environments outside of traditional medical care facilities such as clinics, offices, and hospitals.
Cooper’s emergency department has an annual census of approximately 80,000 patients, of which approximately 25 percent arrive by EMS. As the regional Level I Trauma Center, Level II Pediatric Trauma Center, and a tertiary care facility, Cooper receives patients from the city of Camden and from the surrounding communities within southern New Jersey. In 2016, we became the new provider of EMS in Camden giving our fellows and residents direct involvement in both the development and maintenance of the city’s EMS system, with potential for additional projects involving EMS given the unique urban healthcare economics, such as Mobile Integrated Health Care.
New Jersey EMS has a unique two-tiered system, providing both Basic and Advanced Life Support services. Basic Life Support (BLS) services are generally responsible for patient hospital transports and include both career and volunteer providers. Mobile Intensive Care Units (MICUs) are operated by licensed, acute-care hospitals and are bound by a state-issued certificate of need, which allocates sole-provider service areas to specific hospitals. The JEMSTAR Air Medical Program was designed to provide rapid emergency transport and care for trauma patients in New Jersey. Several privately-operated air medical providers are also licensed to provide scene and inter-facility transports.
Through the Division of EMS/Disaster/Transport Medicine, our physicians provide medical direction for many EMS agencies in southern New Jersey, transport companies, and Cooper 1. Our robust medical direction program promotes physician involvement with agencies to empower the EMS community to provide the highest level of carethrough standardized protocols, online medical command from our emergency department, chart review, real-time feedback at scenes, competency-based training, and open lines of communication with the EMS Medical Directors. More importantly, the team has built relationships with various public and private stakeholders to offer support and expertise during routine and disastrous times and has participated in local, regional, and state initiatives involving EMS and Disaster Medicine. As the Southern Regional Medical Coordination Center, our regional health preparedness and response facility supports the integrity of the health care system during a large-scale event or a public health emergency. Responsibilities include the collection and collation of regional health information, situation awareness, the monitoring of health care system performance and capacity, support to health care system logistic requests in coordination with state and local agencies, and other operations as determined by the NJ Department of Health.
Since the development of an EMS fellowship in 2012, our fellows have been successful in pursuing opportunities within EMS. Graduated fellows have successfully expanded roles within EMS to include medical directorships, creation of new EMS programs in Tactical and Wilderness EMS, and political support for the EMS community. Fellows have been recognized by the EMS community, peers, and governmental bodies as leaders in the field of EMS during and after their fellowship training.
Despite the dynamics of a new fellowship program, our first fellow to graduate in 2017 took the opportunity to make a significant impact to the program. His feedback regarding orientation, the didactic series, the EMS field experience, and overall curriculum will help with the recruitment and training of future EMS physicians. With this success, relationships between the fellowship program and Cooper EMS have been established to provide future fellows the experience of a busy urban EMS system. As a result, Cooper has invested in a second physician response vehicle to support the fellowship program and overall physician response to field calls.