Basic and provisional
Basic training comprises PGY1 and PGY2. The aim is to gain a broad range of experience and the acquisition of basic skills in medicine through a variety of hospital and associated posts.
Provisional training becomes more specified to emergency medicine skills. Requirements include:
- a compulsory six-month term in emergency medicine;
- a further six months in either emergency medicine or another discipline;
- completion of the primary examination; and
- the provision of three structured references.
The advanced training program is of four years duration with a requirement that 30 months is spent in emergency medicine over a minimum of two sites, one of which must be designated as major referral and one as urban district or rural/regional.
During advanced training, trainees acquire and demonstrate the knowledge, skills and attitudes that are outlined in the fellowship curriculum as being required for good clinical practice in emergency medicine. The balance is non-emergency department training, where trainees learn and experience more detailed aspects of related disciplines. The curriculum is described in the Training and Examination Handbook.
There is no selection process for trainees entering either basic or provisional training. The program is open to any registered medical practitioner.
Trainees undergo a selection process for advanced training although there is no quota applied. Selection to advanced training requires successful completion of 12 months provisional training, a pass in the primary examination and satisfactory structured references. Trainees satisfying all these requirements will move into advanced training.
Assessment of this training component is via the completion of In-Training Assessments (ITA) that record the trainee’s performance in various domains of learning and assessment as related to aspects of the fellowship curriculum. Domains include: knowledge and basic skills; clinical judgment; practical skills; professional relationships and communication; ability to perform under stress and different workloads; sense of responsibility and work ethic; motivation and commitment to self directed learning; supervision and education of junior medical staff; and research and quality improvement.
Structured references that assess these domains are supplied by the supervisor of training and two others.
The primary examination examines the basic sciences of anatomy, pathology, physiology and pharmacology as relevant to emergency medicine.
There is a requirement that competence is achieved in the management of paediatric emergencies evidenced by completion of a logbook. A research component is to be completed during either provisional or advanced training.
Assessment continues via the completion of In-Training Assessments, as described under provisional training, and the fellowship examination.
The fellowship examination is an exit examination taken in the last year of training. The criteria are set with the issues of safe specialist practice foremost in mind. The examination consists of six sections. Candidates must pass at least four sections with specified total scores depending on the number of sections passed.
Overseas Trained Specialists
For those OTSs seeking fellowship of the ACEM (FACEM), the college conducts an assessment of the OTS’s qualification in line with that recommended by the Australian Medical Council (AMC). Key assessment tools are the applicant’s curriculum vitae; response to the questionnaire regarding consultant posts held; referee reports; and response at a structured interview.
The interview addresses the applicant’s basic qualifications; advanced qualifications; experience; research and publications; education and teaching; emergency medicine administration; topical issues in emergency medicine; and knowledge of, and attitude towards, the college. A written report is sent to the council. The Board of Education also reviews the recommendation.
Outcomes can include election to fellowship without further requirements, a period of supervised practice in a multi-FACEM emergency department, completion of the research regulation, completion of the fellowship examination or a combination of these.
Assessment of OTSs for an Area of Need (AON) position also follows that laid out by the AMC. Assessment for fellowship requirements will now be conducted along with the AON assessment. The recommendation of the applicant as suitable for the AON post does not imply the applicant has demonstrated satisfactory comparability with a FACEM.
Hospital emergency departments meeting minimum criteria as stated in the Guidelines for Adult and Mixed Emergency Departments Seeking Training Accreditation are accredited for either six, 12 or 24 months of emergency medicine training.
Consideration will be given to staffing levels, case mix of patients, design and equipment, support services, the education and research program, accreditation of other specialties within the hospital and the impact of access block.
Inspections are carried out at the request of a hospital seeking accreditation or as part of a 5-year cycle of reinspection. A team of three senior fellows visits the hospital and meets with staff of the emergency department and other senior staff. The outcome is discussed by the team and reported to the Board of Education and then to Council, where the decision is made.