This has two aims:
1. To consolidate the trainee’s EM practice by increasing experience of the common presentations. During this time trainees will become more expert in their diagnosis and management competences. They will develop an increasing realisation of the range of presentations and the impact of co-morbidities. They will appreciate atypical presentations especially in the elderly and immunocompromised and recognise apparent benign presentations that indicate potential serious pathology.
Trainees will be able to look after sicker patients with increasing confidence, using investigations more selectively with more accurate interpretation. Trainees will develop more detailed differential diagnoses focusing on the worst as well as the most probable. Trainees will supervise others, being supportive but also able to detect when greater input is needed for the safe care of the patient, and will develop a greater understanding of human factors and the non-technical skills needed for work in the ED.
They will develop the leadership and supervisory skills to enable them to take on these roles in the next phase of training.
2. The trainee will focus on the common paediatric presentations to the ED and these are laid out in the same way as for adults, with additional areas that are unique to children. The trainee must have successfully completed an APLS course or equivalent during this third year (the earlier thebetter).
By the end of the third year the trainee will have completed all the assessments (including the FRCEM Primary and Intermediate Certificate) and be ready to work unsupervised (but with access to senior advice at all times) and to supervise others, ensuring safe, effective and timely care.
Transition arrangements for Defined route of entry EM trainees Trainees entering from an alternative core training programme will have successfully
achieved many competences, some of which are directly transferable to EM.
During the period of transition, to be ready for progression to ST4, the DRE-EM route trainee will need to achieve all of the required competences for ST4 entry.
In addition to a period of one year spent within EM (which may be reduced by up to six months if a period of approved training within EM during core training has been undertaken and the requisite competences achieved- specifically NOT during Foundation training), the trainee will undertake up to one year achieving competences in acute medicine, ICM and anaesthesia. This one year period will comprise training periods of 3-6 months in each of these three elements.
This period may be reduced if the trainee has achieved the required competences during a period of training in one or more of these three components during their prior training