ST3 defined route of entry into emergency medicine: a new recruitment process
BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1794 (Published 03 March 2014) Cite this as: BMJ 2014;348:g1794
- Julie Honsberger, senior business manager
- julie.honsberger{at}yh.hee.nhs.uk
Abstract
Emergency medicine struggles to attract enough trainees to fulfil the workforce requirements of the specialty. Julie Honsberger describes a new entry point into the third year of specialty training that is designed to improve recruitment to the specialty
As warnings continue about the problems facing emergency departments, among the most pressing issues facing emergency medicine is the need to improve the recruitment and retention of doctors to the specialty. One of the College of Emergency Medicine’s 10 priorities for resolving the “crisis” in emergency medicine is to establish transferable competencies to encourage more doctors to join the specialty and to enable them to do so. A new entry point into the specialty has been established to help achieve this.
In April 2014, for the first time, a cohort of doctors entering the third year of emergency medicine specialty training will be appointed through a national selection process. This entry point into emergency medicine has been named “defined route of entry—emergency medicine” (DRE-EM). It was developed by the College of Emergency Medicine, in conjunction with Health Education Yorkshire and the Humber, the lead local education and training board in England for emergency medicine.
There is no upper limit on experience or time for DRE-EM applicants, and the intention is to allow entry from a broad range of applicants. However, applicants will have to show that their career progression is consistent with personal circumstances and that their achievements and performance are commensurate with their total period of training or experience.
Applications to DRE-EM opened on 3 February 2014 and will close on 10 March 2014. Interviews will take place in April, hosted by Health Education Yorkshire and the Humber. DRE-EM provides run-through training, and so successful applicants will progress automatically through the third, fourth, fifth, and sixth years of specialty training (ST3 to ST6), subject to meeting all curriculum requirements and passing the necessary college exams.
The person specification for DRE-EM will allow potential applicants to see more easily how their skills and experience fit within the two routes into emergency medicine (see box). Dependent on previous training experiences, some people will be eligible for a certificate of completion of training at the end of the emergency medicine training, whereas others will go through the certificate of eligibility for specialist registration—combined programme route.
DRE-EM allows those applicants with surgical or acute care common stem competencies (as outlined in the person specification) to “transfer” their competencies into emergency medicine and for them to count towards their training. Before 2014, an individual who successfully completed core surgical training could apply to emergency medicine only via acute care common stem emergency medicine ST1/core training year 1 (CT1) national selection, whereas through DRE-EM, these individuals can apply to ST3 emergency medicine and have their competencies recognised, meaning applicants are not required to restart from the beginning.
Successful DRE-EM applicants will be offered an appointment to an ST3 emergency medicine post. Before the applicant starts in the post, the College of Emergency Medicine, in conjunction with the local training programme, will undertake a review to define transferable competencies and establish future requirements. A decision will be made as to the additional time or competencies required before the applicant moves to ST4 emergency medicine.
Successful applicants will usually do a minimum of one year in emergency medicine, plus additional time as needed in other specialties such as acute medicine, anaesthesia, and intensive care medicine. Applicants will normally require between 12 months and 24 months at ST3 level before progressing to ST4 emergency medicine.
Certificate of completion of training route
One route into the specialty is to enter into emergency medicine specialty training after successfully completing either two years of a UK core surgical training programme or two years of a run-through surgical training programme in the United Kingdom. This route requires evidence of achievement of certain competencies. At the time of application, applicants must have achieved surgical competencies from the first year of either core training (CT1) or specialty training (ST1). Before they start the post, they must have achieved competencies in surgery for the second year of core training (CT2) or specialty training (ST2). Entry via this route leads to a certificate of completion of training in emergency medicine.
Certificate of eligibility for specialist registration—combined programme route
The other route is to enter into emergency medicine specialty training with evidence of experience of a minimum of 24 months at core trainee level (not including time spent within a foundation programme or equivalent). This experience can be in any of the acute care common stem specialties (anaesthesia, emergency medicine, intensive care medicine, or acute medicine). At least 12 months of this experience must be in emergency medicine, and at least six months of this must be in an emergency medicine environment similar to that in the United Kingdom. Applicants must also have completed 12 months of work in the United Kingdom as a fully registered medical practitioner. Alternatively, applicants are eligible if they have achieved the equivalent of core surgical training (with evidence of achievement of CT/ST1 competencies in surgery at the time of application and CT/ST2 competencies in surgery by the time of appointment). This route leads to a certificate of eligibility for specialist registration—combined programme in emergency medicine.
Footnotes
Competing interests: I have read and understood the BMJ Group policy on declaration of interests and have the following relevant interests to declare: I am employed by Health Education Yorkshire and the Humber, the lead local education and training board for emergency medicine.