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MSF-OCB Emergency Medicine – Intensive Care

Emergency Medicine and Intensive Care Doctors

Check list

Name of applicant: .......................................................

Date of application: .......... / .......... / ..........

Did you pass a post-graduate training program in Emergency Medicine ? Yes No 

Did you pass a post-graduate training program in Intensive Care ? Yes No 

I Yes! "#at "as t#e duration o t#at training ? $$$$$$$$$$ $$$$$$$$$$

I Yes! "#en did you %ua&iy ? $$$$$$$$$$ '$$$$$$$$$$ ' $$$$$$$$$$

(&ease speciy t#e name and address o t#e )niversity "#ere t#is program "as

de&ivered*

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

+s a full-time Emergency Medicine doctor! #o" many years o e,perience do you

#ave ? $$$$$$$$$$$$ years

+s a full-time Intensive Care doctor! #o" many years o e,perience do you

#ave ? $$$$$$$$$$$$ years

I you #ave not passed any training in Emergency Medicine! #o" many years o

e,perience "oring in an Emergency Department do you #ave?$$$$$$$$$$$$$$$$$ years

I you #ave not passed any training in Intensive Care Medicine! #o" many years o

e,perience "oring in an Intensive Care )nit do you #ave?$$$$$$$$$$$$$$$$ years

+re you +.S certiied ? Yes No 

(Please provide your valid certificate)

+re you +/.S certiied ? Yes No 

(Please provide your valid certificate)

+re you (+.S or +(.S certiied ? Yes No 

(Please provide your valid certificate)

+re you an instructor in any o t#ese speciic trainings ? Yes No 

(Please specify).............................................................

+re you %ua&iied in disaster medicine or mu&tip&e casua&ty management ? Yes No 

(Please specify).............................................................

+ny ot#er %ua&iication you "ou&d &ie to mention ?

(Please specify).............................................................................................................

8/17/2019 emergency_medecine_and_icu_check_list.doc

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MSF-OCB Emergency Medicine – Intensive Care

echnical skills :

 Not trainedOn&y under 

supervision

+utonomous

 practice E,pert

Bag-va&ve-mas

venti&ation

 Non-invasive

venti&ation

Intu0ation

1enti&ator settings

(rocedura& sedation

+naest#esia

C#est drain insertion

F+S/ u&trasound scan(ICC access

Intra-osseous access

Centra& venous access

EC2 interpretation

/#rom0o&ysis or +CS

Conservative racture

management

Burn management

3ound care

(syc#iatry(re-#ospita& care

End o &ie care

 Norma& de&iveries

Caesarean section

Fasciotomy

Signature o app&icant*

Many t#ans or comp&eting t#is orm$