Contents lists available at ScienceDirect African Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/afjem EDITORIAL The Urgent Need for Postgraduate Medical Training in Emergency Medicine in Nigeria Emergency medicine is a standalone field of medicine which has developed over decades to become the bedrock of emergency care in developedcountries.Itisafairlynewspecialty,whichstartedtoreceive recognition in the late ‘60s and early ‘70s as a distinct specialty, out of the need to care for a growing population of unscheduled and un- differentiated patients who needed immediate medical care [1]. Theemergencymedicinetrainingframeworkisindifferentstagesof development in Africa. It is highly developed in some parts of the continent, yet remains rudimentary and virtually non-existent in other parts. The flagship emergency medicine residency training program in Africa began in the University of Cape Town in 2004 [2], after which several programs in other African countries such as Botswana, Egypt, Ethiopia, Ghana, Kenya, Libya, Malawi, Mozambique, Rwanda, Sudan andTanzaniasprangup.Asof2017,therewere15emergencymedicine residency training programs across 12 countries in Africa [3]. A structured residency program was pioneered by Ghana in 2009 throughcollaborativeeffortsoftheDepartmentofEmergencyMedicine at University of Michigan, Komfo Anokye Teaching Hospital, Ministry of Health, Ghana Ambulance Service, Kwame Nkrumah University of ScienceTechnologyandTechnology(KNUST)andtheGhanaCollegeof Physicians and Surgeons (GCPS) to meet the country’s emergency care needs [4]. Unfortunately, only this small West African country with a population of about 30 million people has been able to achieve this in the West African sub-region [3]. Postgraduate medical training in Nigeria, the most populous country in Africa, is under the purview of the West African College of Physicians and Surgeons and the National Postgraduate Medical College of Nigeria. Sadly, both institutions which should cater for the trainingneedsoftheWestAfricanSub-region,currentlylackprovisions for emergency medicine training [5–7]. Yet, countries in Sub-Saharan Africa are responsible for a high burden of morbidity and mortality from acute illnesses of communicable (malaria, tuberculosis and HIV) and non-communicable aetiology (cardiovascular disease, diabetes, etc.)[8].Thelackofaformalpre-hospitalemergencyresponseset-upin Nigeria further complicates the state of emergency care in Nigeria [9]. Okonofuacorrectlyidentifiedthatpartoftheweaknessofpostgraduate medical education in Nigeria is the lack of review of training curricula [7]. It is therefore urgent to reorganize emergency services in Nigeria. The government and leadership of the postgraduate colleges need to work hand-in-hand to develop legislature and policies that would en- ablethecommencementoftraininginemergencymedicine.Facultycan be drawn from a repertoire of sources including Emergency medicine specialists and fellows from neighbouring countries and in diaspora. Government can sign agreements with established institutions (e.g. the Royal College of Emergency Medicine, Emergency Medicine depart- ments of Universities in countries with training programmes) whose models can be easily adopted and modified to suit our peculiar en- vironment and needs. Also, as doctors do not work in isolation, we advocate that nurses and pre-hospital care providers (including the emergency ambulance service) should undergo formal training in emergency medicine to improve quality of care. Furthermore, the state of tertiary hospitals in the country (especially as regards equipments and infrastructure required for emergency response) needs to be im- proved upon, in order to be able to support emergency medicine training, while offering emergency care to patients that require it. Declaration of competing interest We have no conflict of interest to declare. Appendix A. Supplementary data Supplementary data to this article can be found online at https:// doi.org/10.1016/j.afjem.2019.09.003. References 1. Sakr M, Wardrope J. Casualty, accident and emergency, or emergency medicine, the evolution. Emergency Medicine Journal.[Online]2000;17(5):314–319.Availablefrom: doi:10.1136/emj.17.5.314 2. Wen LS, Geduld HI, Tobias Nagurney J, Wallis LA. Africa’s First Emergency Medicine Training Program at the University of Cape Town/Stellenbosch University: History, Progress, and Lessons Learned. Academic Emergency Medicine. [Online] John Wiley & Sons, Ltd (10.1111); 2011;18(8): 868–871. Available from: doi:10.1111/j.1553-2712. 2011.01131.x 3. Sawe HR, Akomeah A, Mfinanga JA, Runyon MS, Noste E. Emergency medicine re- sidency training in Africa: overview of curriculum. BMC Medical Education. [Online] BioMed Central; 2019;19(1): 294. Available from: doi:10.1186/s12909-019-1729-1 4. Emergency Medicine in Ghana. Ghana Medical Journal. [Online] Ghana Medical Association; 2015;49(3): 124. Available from: https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC4676596/ 5. West African College of Surgeons | Faculties. [Online] Available from: http://www. wacscoac.org/index.php/faculties 6. West African College of Physicians | About Us. [Online] Available from: https://wac- physicians.org/pages/about-us.php https://doi.org/10.1016/j.afjem.2019.09.003 Received 8 July 2019; Received in revised form 3 August 2019; Accepted 9 September 2019 African Journal of Emergency Medicine 10 (2020) 1–2 Available online 18 November 2019 2211-419X/ © 2020 African Federation for Emergency Medicine. Publishing services provided by Elsevier. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/). T