Many Challenges, Many Successes

Despite the obvious improvement in patient care we provided, the specialists felt threatened, particularly the cardiologists. They did not understand our scope of practice. How could a physician who was not a cardiologist manage ventricular tachycardia or cardiovert atrial fibrillation patients? We were not even allowed to intubate, as that was the anesthesiologists’ job. Despite having diagnosed tamponade, dissection, and several aortic aneurysms by bedside ultrasound, I was accused of not being trained as a radiologist. Our CEO stepped down after a staffing conflict with the nurses’ union, so we lost our support at the top. After almost one year, all success aside, our pilot program was shut down.

But it was too late to stop the momentum that had started. In 2015, the Norwegian Society for Emergency Medicine (NORSEM), which had been formed in 2010 by a Norwegian emergency physician who had trained in the United States (and of which I am a board member), was asked by the Ministry of Health to help develop an education framework and curriculum for a primary specialty in emergency medicine that would comply with EUSEM’s curriculum and international guidelines. In 2017, the Minister of Health approved emergency medicine as Norway’s newest specialty. One year later, NORSEM joined the International Federation for Emergency Medicine as a full voting member. In March 2019, the Ministry of Health began accepting applications from those physicians wishing to be grandfathered in as Norway’s first emergency medicine physicians. On Oct. 17, 2019, I received confirmation that I was to be one of them. The process of approving training facilities is currently under way.

More than two decades ago, during residency, I took my first trip to Norway and had a tour of an akuttmottak in Oslo. I knew at that time that someday I would like to work as an emergency physician in Norway. I knew I would first have to learn the language. I didn’t know that I would have to help create the entire specialty. It was a pipe dream, but with hard work, good timing, and a little luck, that pipe dream came true.

I’m back in the States now with no immediate plans to move back to Norway. But if and when I do, I can proudly work as an emergency physician. 

Dr. Galletta is associate professor of emergency medicine at the University of Massachusetts in Worcester.