The specialities of emergency medicine, intensive are and pre-hospital medicine are rapidly evolving, however they are becoming extremely popular career choices for medics. It may be several years away from you actively selecting a specilaity pathway, however, we hope on this page that we can provide you with details relevant to chosing a career in a STEP associated speciality. Read through the details below and follow the links to read about how others have gone about it and how one might chose to train to become a pre-hospital specialist. We hope this information will:

• Provide you with a clearer understanding of the various pathways open to future graduates
• Encourage you in the selection of a pre-hospital associated speciality
• Enable you to access approriate resources to help you gain exposure to pre-hospital medicine

STEP are working on a series of programmes that will allow you to access observation shifts as well as local training sessions focussed on pre-hospital care. Once these become operational we will update this site with the details. These experiences will help you decide if a career in pre-hospital care is something for you and also allow you to learn more about the type of work and skills this speciality includes.

Training Pathways

The Acute Care Common Stem (ACCS) is becoming a popular choice for medics interested in the STEP speciality areas, however other specialist pathways including general medicine and surgery are possible too. It allows you to develop skills in several specialist fields, providing you with a variety of learning opportunities and clinical skills that are called upon in many emergency and pre-hospital settings. The ACCS enables you to follow a specialist career, towards a CCT in any of the parent specialities as well as Intensive Care Medicine, General Internal Medicine and academic training posts.

With regards to beginning Pre-Hospital work the West Midlands CARE Team advise that doctors are able to enrol in their organisation once in ST1 or above along with other requirements such as ALS qualifications and at least 12months acute speciality training. Prior to this there may be opportunities for observation shifts alongside Pre-Hospital doctors or paramedics, however clinical exposure will of course be limited as in observation role only.

The ACCS pathway works as follows (details taken from ACCS site July 2011):

Consider reading Nitin Jain's article on the Trainee's Persepective of ACCS.

Profiles

• Dr David Raven is a relatively newly appointed consultant in Emergency Medicine at Heartlands Hospital Trust and although his training began before the current training programmes were in place, he did complete his training in the new system and has kindly shared with STEP@Warwick his experiences in training.

Links

• An ST3 in anaesthetics and intensive care medicine describes his career progression into pre-hospital medicine
• The Acute Care Common Stem (ACCS) is now one of the forefront pathways into work such as pre-hospital, enabling expereince in various acute settings
• The College of Emergency Medicine is a relatively new college directing the training in this growing speciality
• The Faculty of Intensive Care is a branch of the Royal College of Anaesthetists, paving the way for a new trainee programme in Intensive Care
• West Midlands CARE Team are a voluntary group that provide dedicated emergency response services in collaboration with WMAS to traumatic cases