Medical Training Review Panel: Seventeenth Report

Australasian College for Emergency Medicine

Page last updated: 09 April 2014

Training Program

Basic and Provisional

Basic training of the Australasian College of Emergency Medicine (ACEM) 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.

Advanced

The advanced training program is of four years duration with a requirement of 30 months 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 under Emergency Medicine Training on the ACEM website.

Trainee Selection

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.

Trainee Assessment

Provisional Training

Assessment of this training component is via the completion of ITAs 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 ACEM Fellows (FACEMs).

The primary examination examines the basic sciences of anatomy, pathology, physiology and pharmacology as relevant to emergency medicine.

Advanced Training

There is a requirement that competence is achieved in the management of paediatric emergencies evidenced by completion of a logbook or a placement in paediatric ED. A research component is to be completed, during either provisional or advanced training, either via coursework or project pathway.

Assessment continues via the completion of In-Training Assessments, as described under provisional training, and the fellowship examination.

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 a written component (MCQ and written short answer papers), and a clinical component (of short and long cases and a six station structured clinical exam).

Overseas Trained Specialists

For those overseas trained specialists seeking fellowship of the ACEM (FACEM), the college conducts an assessment of the overseas trained specialist’s qualification in line with that recommended by the 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 and outcome recommendations are sent to the College council for approval.

Outcomes can include election to fellowship without further requirements, a period of supervised practice in an ACEM accredited emergency department, completion of the research regulation, completion of the fellowship examination or a combination of these.

Assessment of overseas trained specialists for an Area of Need (AoN) position also follows that laid out by the AMC. The college reviews the AoN position description and assesses the applicant’s qualifications to determine if they are suitable for the position. The recommendation of the applicant as suitable for the AoN post does not imply the applicant has demonstrated satisfactory comparability with a FACEM. Assessment for fellowship requirements can now be conducted along with the AoN assessment (concurrent assessment).

Accreditation

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 two 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 where the decision is made.

Further Information

Additional information, including details of the ACEM Curriculum Revision Project and revised training requirements to apply from 2015, is available from:

Australasian College for Emergency Medicine

www.acem.org.au