Saudi Journal of Emergency Medicine

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Mobarak Al Mulhim et al, 2020;1(1):032.

Saudi Journal of Emergency Medicine

A look into a new evolving medical specialty, “Dignitary Medicine”

Mobarak Al Mulhim*

Correspondence to: Mobarak Al Mulhim

*Beth Israel Deaconess Medical Center - Harvard Medical School, USA.

Email: kfshed [at]

Received: 29 December 2019 | Accepted: 30 December 2019

We believe the readers of SJEM will take great interest in our recent work on the burgeoning field of Dignitary Medicine (DM). Historically, there are significant lessons learned from medical catastrophes that affected or killed leaders from all over the world, all of which highlighted the importance of the physicians—leaders’ relation (When Illness Strike the Leaders—by Jerald Post). We always assume that leaders as VIP get the best health care, while in fact their health outcome are compromised by many factors, including the inner circle interference and their families influences, but also the lack of physician special training [1]. DM involves caring for government leaders, their family, and other high-profile individuals, generally referred to as dignitaries.

Dignitaries require 24/7 access to complex care, mitigation against unique threats, such as assassination, coordination of medical care with security services and an inner circle of advisors, and greater medical record privacy than the average patient [2]. Given the complexities of managing such patients, we have proposed DM as a novel area of medical specialization and training.

As a first step toward training physicians in DM, a consensus panel of experts from around the globe recently convened and using the Delphi methodology, created a framework for a curriculum that could serve as the basis for advanced training and potentially even fellowship level training (Mulhim, Darling, R, Sarin, R et al. A Dignitary Medicine Curriculum Developed Using a Modified Delphi Methodology. Publication pending).

The six domains of competencies were derived from the consensus to include:

  1. Executive health (Hospital based dignitary care)
  2. Protective medicine (Providing medical care and protection round the clock)
  3. Wellness and personalized health
  4. Physician leadership & quality
  5. Knowledge in technological advances (such as tele- monitoring & tele –medicine)
  6. Maintaining clinical skills & competencies in the original specialty & the essential medical emergencies.

We believe that specialists from emergency medicine would be, especially, well suited toward pursuing a career in DM. Additionally, general surgeons, trauma surgeons, internal medicine providers (especially with infectious and tropical disease expertise), critical care doctors and in some cases pediatricians and women’s health experts, would all bring necessary expertise to the field of DM.

We encourage the readers of the SJEM to evaluate our published work, reference 1 below, and await our second article on the subject, forthcoming in 2020.


  1. Al Mulhim MA, Darling RG, Kamal H, Voskanyan A, Ciottone G. Dignitary medicine: a novel area of medical training. Cureus. 2019;11(10):e5962. Published 2019 Oct 22.
  2. Band RA, Callaway DW, Connor BA, Haughton BP, Mechem CC. Dignitary medicine: adapting prehospital, preventive, tactical and travel medicine to new populations.. Am J Emerg Med. 2012;30(7):1274–81.