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Training & Careers > UK Trainee Programmes & Accreditations > Careers in Emergency Medicine
Careers in Emergency Medicine
Careers in Emergency Medicine offer excitement, variety, challenge and reward. Doctors and practitioners
working in Emergency Medicine use their clinical skills and experience to recognise and treat the full spectrum
of emergencies in patients of all ages.
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— Specialty Training
Specialty
Training
Training in Emergency Medicine puts
you at the frontline of medical care
and enables you to develop the
knowledge and skills you need to
manage the breadth of acute
presentations.
During your training you will gain
valuable experience working with a number of multidisciplinary teams in Emergency Medicine and
other acute specialties. You will develop a wide range of clinical skills and competencies that you can
put into action when needed. You will work alongside senior clinicians who will train you “on the job”
and you will attend local teaching and regional training days.
As you progress further through training you will be supported to develop leadership and managerial
skills, such as coordinating patient care across the department and supervising more junior colleagues.
You will be encouraged to develop sub-specialty interests such as Paediatric Emergency Medicine, and
given the opportunity to take time out of program to gain additional experience that will complement
your training. This could involve anything from academic research, developing your skills as a clinical
educator, or practising Humanitarian Medicine abroad.
Finally you will need to pass the fellowship exam (FRCEM) before the end of specialty training, when
you will be awarded a CCT (Certificate of Completion of Training), which means you will be eligible to
apply for a Consultant post in the UK.
Training Pathways
Many doctors’ first experience of working in Emergency Medicine is a four month post during
foundation training. This provides a good opportunity to get a feel for working in an Emergency
Department, and start learning how to assess patients and make decisions with close supervision.
From here, the standard training pathway involves the Acute Care Common Stem (ACCS) (ST1-ST3),
followed by Higher Specialist Training (ST4-ST6), taking a minimum of 6 years. This can easily be
extended by out of programme time, sub-specialty training, or if you wish to work part time. Applicants
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can opt for “run-through training” which avoids the need for re-application after the first three years,
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subject to satisfactory progress.
An alternative route into training is provided by the DRE-EM (Defined Route of Entry into Emergency
Medicine) programme. This is designed for doctors who have already gained additional experience in
Emergency Medicine or other specialties, with entry at ST3 level.
These training pathways are described in more detail below. Of course, a career in Emergency
Medicine is flexible, and many doctors follow a career path that includes time spent out of training or
one that follows a different route altogether.
For an overview of career paths and the links between them, see the EM Career Pathways Map below.
(A pdf download available here)
Acute Care Common Stem (ACCS) ST1-ST3
Most trainees will start with the ACCS core training programme. During the first two years, trainees
rotate through six month posts in Emergency Medicine, Acute Medicine, Intensive Care Medicine, and
Anaesthetics. This broad experience in acute specialties equips you with the confidence and skills to
manage the full spectrum of acutely ill and injured patients.
The third year is focused on gaining further experience in Emergency Medicine, and spending six
months training in Paediatric Emergency Medicine, in preparation for Higher Specialist Training.
As you progress through training you will build an e-portfolio of your learning and achievements,
supported by your educational and clinical supervisors. Your e-portfolio enables you to demonstrate
increasing levels of competency and will be reviewed regularly to ensure you are on track with your
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Prior to entering higher training at ST4 level you also have to successfully complete the FRCEM
Intermediate exams, which are based on the competencies you have been working towards during the
ACCS programme.
• Applying for Specialty Training
• Person Specification for ACCS Application
• Current recruitment timeline
Higher Specialist Training ST4-ST6
As a senior trainee, you will spend your time working in the Emergency Department, consolidating and
finely tuning your clinical skills. You will put them to good use, delivering care to the most seriously
unwell or injured patients as resuscitation or trauma team leader. You will feel confident to approach
any clinical scenario.
You will learn how to safely supervise more junior members of the team, and work with the consultant
to coordinate care on the shop-floor and provide senior review. At other times you will be the most
senior doctor in the department with on-call consultant support.
At other times you will be the most senior doctor in the department with on-call consultant support.
You will learn more about leading and managing the emergency care system, with dedicated
leadership training and a management portfolio that you will build up through supported experience.
You will work towards completing your final FRCEM exams, which bring together all of the knowledge,
skills, competencies and expertise you have learnt during training, and are used to putting into action
in your daily practice.
Defined Route of Entry into Emergency Medicine (DRE-EM)
The DRE-EM programme provides an alternative pathway into specialty training for those with prior
experience of EM and other acute specialties, or those who have completed basic surgical training. It
also provides a method of switching from other ACCS programmes.
DRE-EM takes into account this prior experience and provides an opportunity to enter training at ST3
level. The programme is tailored to individual training needs, with a variable amount of time spent at
ST3, enabling the trainee to gain any missing competencies or experience prior to entering Higher
Specialist Training at ST4.
More information about DRE-EM and eligibility criteria can be found in the Exams & Training section of
the College website.
• DRE-EM Eligibility
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• Person Specification for DRE-EM Application
• Current recruitment information
Sub-Specialty Training
The broad base of Emergency Medicine means that there is huge scope to develop a specialist interest
in almost anything you can think of. Well recognised sub specialties and niche personal interests
happily co-exist. There are two recognised sub-specialties, Paediatric EM and Pre-Hospital EM, and
trainees can also dual-accredit in Intensive Care Medicine. These sub-specialty options lead to
recognised accreditation with the GMC. Trainees competitively apply for these posts during Higher
Specialist Training.
Related pages
College / Membership Pages
About the College & Emergency Medicine
The Royal College of Emergency Medicine works to ensure high quality care for patients by setting and
monitoring standards of care in emergency departments, as well as providing expert guidance and
advice on policy to relevant bodies on matters relating to Emergency Medicine.
Find out more
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Public Information / Support
Clinical Educators in Emergency Departments
(CEED)
Highlighting the need to address issues of staff retention and burnout within Emergency Departments.
Find out more
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Training & Exams
Continuing Professional Development (CPD)
Resources, tools and guidance on Continuing Professional Development (CPD).
Find out more
Contact
Royal College of Emergency Medicine,
Octavia House,
54 Ayres Street,
London, SE1 1EU.
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