Training and development (EM)

This page provides useful information on the training and development for this specialty and also has tips for people at all stages of their training including medical school.

Specialty training

Trainees may enter the emergency medicine training programme via:

  • the acute care common stem (ACCS) EM core programme at CT1. ACCS (EM) is a three year core training programme - CT1 -3. This includes six months in each of EM, Intensive Care Medicine, Anaesthetics and Acute Medicine for the first two years and than a further year focusing on trauma and paediatric EM. NB An EM run-through training pilot commenced in 2014. It is the trainee's decision whether to accept the post as a CT1 post or an ST1 (run through) post. Entry into ACCS (EM) training is by competitive application at CT1/ST1
  • from ST3 via the defined routes of entry into emergency medicine (DRE-EM) subject to meeting the entry criteria (see the Royal College of Emergency Medicine Curriculum document for further details). One of these routes is from surgical training and one from ACCS
  • at the start of specialty training (ST4-6) subject to having achieved the necessary competences required for completion of ACCS and CT3/ST3

Emergency Medicine trainees who have already been accepted for higher specialty training may apply to train in ICM as well as EM to obtain a Dual CCT. It will usually extend the training programme to 8.5 years with the special skills year being spent in Emergency Medicine. Further details can be obtained from the Faculty of Intensive Care medicine website.

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 subspecialty 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. Not all programmes are able to offer this sub-specialty training. Appointments are on a competitive basis. Trainees must hold a training number and be in HST (ideally the final year) before they can be appointed to a sub-specialty training post.


Prehospital emergency medicine (PHEM) is also a recognised subspecialty of Emergency Medicine. Entry into PHEM training is by competitive entry, and may be integrated into EM training over a two-year period, or be stand alone, over one year. Entry to PHEM training is by competitive application. Not all programmes are able to offer this sub-specialty training. Trainees must hold a training number and be in HST before they can be appointed to a subspecialty training post.

A significant proportion of the trainees in EM are training less than full time.

Each level of entry onto emergency medicine training has a person specification that lists the required competences for that specialty. When making an application, you will need to provide evidence proving that you have achieved the specified competences.

The approved postgraduate training programme for EM is available from the GMC.

    • join your university medical society
    • attend conferences for medical students – this will give you an opportunity to network and meet your future colleagues
    • get involved with the GMC (General Medical Council), eg medical students can participate in visits to medical schools as part of the GMC’s quality assurance process
    • consider joining the specialist society for your chosen specialty as a student member, eg the Royal College of Emergency Medicine
    • consider becoming a student member of the BMA (The British Medical Association is the trade union and professional association for doctors and provides careers advice)
    • make your specialty decision in good time so that you can test it out before committing yourself, eg by using hospital visits and clinical placements arranged as part of your course to ask questions and observe people at work
    • choose the topic of your supervised research project carefully to test out your thinking
    • remember your first priority is to demonstrate that you have developed the personal, learning, clinical, practical and management skills needed by all doctors
    • think laterally when applying for rotations – vacancies may not be available in emergency medicine so apply for a rotation in a related field such as acute internal medicine or general internal medicine
    • talk to your clinical and educational supervisors about particular areas of interest to explore
    • use full placements to experience specialties that you might be interested in or apply for taster experiences if you can’t get a placement
    • talk with your peers about their career ideas and experiences – you may be able to help each other
    • listen to information and advice from more experienced doctors but make your own decisions
    • taking part in a clinical audit is important for your development as a doctor but you may be able to choose an audit project related to a specialty that interests you
    • ensure your Foundation e-portfolio has plenty of medical evidence and that this is kept properly up-to-date
    • try to gain teaching and management experience
    • look at competition ratios (ie the number of applicants to places) critically. Find out what is happening this year and spot any regional differences in competition ratios
    • view the careers resources on the Foundation Programme website
    • write a BestBET or get involved in research
    • complete relevant modules on the RCEM learning site
    • attend Royal College of Emergency Medicine training and careers days
    • ensure a good grounding in emergency medicine
    • speak to consultants about what the role is like
    • read as much information as you can on the websites of relevant professional bodies
    • impress interviewers by showing that your interest in the specialty is intrinsically motivated, ie you are drawn to the work and not just attracted by admiration of someone you have shadowed (You will also be happier in your career in that specialty many years later!)
    • be prepared to move to where the vacancies are
    • continue to develop your practical and academic expertise
    • undertake a research project
    • try to get some of your work published and present at national and international meetings
    • join or start a Journal Club (a group who meet to critically evaluate academic research)
    • teach junior colleagues
    • take on any management opportunities you are offered
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