ACCS and EM Training Guide

This is a basic guide on how training is completed from start to finish, we are currently modifying this to be more useful.

CT1/ST1 and CT2/ST2 – The Acute Care Common Stem: The Acute Care Common Stem (ACCS) comprises one year of training in EM and Acute Internal Medicine (AM). The second year comprises Anaesthesia and Intensive Care Medicine (ICM). The split within each year and order in which the specialties are completed will vary according to LETB/deanery arrangements. Competences in all four specialties must be achieved. In North-East Scotland you will have the option to do your first year in Inverness but everyone comes back to Aberdeen for the second year.

CT3/ST3 – ACCS specialty specific year: For the third year of core training ACCS doctors return to their parent specialty. EM trainees will complete a year which will mostly be spent in the Emergency Department.  CT3/ST3 Emergency Medicine:Trainees will normally complete 6 months of general EM during their CT3 year. The purpose of this training is to consolidate the competences acquired in ACCS and develop the leadership and management skills required for progression to ST4.

All trainees must achieve CT3 competences in Paediatric EM. The key objective of this element of the programme is to achieve the competences required to care for children in the Emergency Department as defined in the curriculum. The preferred model would comprise at least six months experience in EM with a paediatric focus, plus some focussed additional training in acute general paediatrics/neonates. At least three months of this training should ideally be in a department recognised for paediatric EM sub-specialty training. This year is spent in Aberdeen where you will get a mix of both Paediatric and Adult EM, there is dedicated time to gain paediatric competencies.  In addition to this a new mentorship programme is being developed where you will get the opportunity to be on nightshift with a more senior trainee so as to learn about the challenges overnight in a safe way.

ST4 – ST6 – Emergency Medicine:Most trainees will spend the ST4 to ST6 years in the emergency department. EM Schools (or STCs) are responsible for ensuring that each trainee is exposed to the full range of Emergency Medicine practice in a balanced rotation. All training rotations must allow experience in at least one teaching centre and one district general hospital emergency department. Trainees should spend approximately 25% of their total time in years ST4-6 caring for children.  An option to spend time in Inverness is offered during this period as well.

Sub-specialty training in Paediatric Emergency Medicine:

Paediatric Emergency Medicine is a recognised sub-specialty of Emergency Medicine. The training consists of six months in a Paediatric Emergency Medicine department approved for sub-specialty training and six months of ward-based paediatrics, three months of which should be in the care of unconscious and critically ill children, such as in a Paediatric ICU. Aberdeen is able to offer this to senior trainees via an application process.

Sub-specialty training in Pre-Hospital Emergency Medicine:

Trainees can apply for Pre-Hospital Emergency Medicine (PHEM) sub-specialty training in their ST4 year. PHEM training programmes will be available through a national grid application and will consist of 12 months whole time equivalent training. The Intercollegiate Board for Training in Pre-Hospital Emergency Medicine strongly supports blended training (mixing base specialty with PHEM training) to reflect future working patterns and giving trainees sufficient time to consolidate information. Many programmes will therefore last two years, and in this time trainees will undertake the equivalent of one year of PHEM training and one year of specialty training. Aberdeen is developing a pre-hospital service which will strengthen any applications to PHEM training, it also benefits from experienced PHEM consultants who can help guide trainees to achieve their goals.

Dual accreditation with Intensive Care Medicine:

Intermediate & Advanced Level Accreditation in Intensive Care Medicine (ICM) is available for EM trainees as regulated by the Faculty of Intensive Care Medicine. This type of training is available on a competitive basis and leads to a dual CCT in ICM and EM, but only when both training programmes have been completed. Not all programmes will be able to offer, or trainees able to pursue, dual accreditation. This extends specialty training as guided by the ICM Board.This guide has been created by the College of Emergency Medicine.