Professional Documents
Culture Documents
Accident Hospital
PG Training Structure 1980-1995
Pre-registration year
My Training 1980-91
• 5 yrs HO+SHO
• 2.5 yrs Registrar
• 3.5 yrs SR
• 12 hospitals
• FRCS Ed
1980s:
• 1983 First diet of FRCSEd (A & E) - became MRCSEd (A&E)
subsequently. Final diet in 2009.
• 1984 Australasian College of Emergency Medicine established
• 1986 1st International Conference Emergency Medicine London
• 1988 BAEM British Association A&E Medicine: Journal A&E M
PLUS Archives of Emergency Medicine journals.
• ATLS at RCS and ACLS
Archives of Emergency Medicine, 1988
Adequacy of senior registrar training in accident and emergency
medicine over the last 5 years
P. DRISCOLL, A. COPE & S. A. D. MILES
SUMMARY
This study investigated the limitations of the present Senior Registrar training
programmes in A&E Medicine. A completed questionnaire was returned from 46 of
the 48 Consultants who had taken up post in the last 5 years and had themselves
studied on one of the established training programmes.
The positive views of the clinical training contrast sharply with the administrative
and managerial components. Around 80% of the new Consultants had no training in
clinical budgeting or ordering equipment and only half had experience of
appointing staff and organizing locums. This is worrying as over 63% had or are
currently facing staffing problems and 69% have financial or equipment difficulties.
A more active training programme in A&E administration and management is
recommended.
1990s
• Consultants make a difference
• Limited training capacity, budgets, output
• 250 A&E Depts to have at least 1 cons, Big EDs 2+
• Old Buildings, crowded A&Es, long waits
1995
European Council Directive
93/16/EEC of 5 April 1993 to
facilitate the free movement of doctors and
the mutual recognition of their diplomas,
certificates and other evidence of formal
qualifications:
4 Freedoms: capital, people, goods,
services.
2nd August 1993: UK ratifies EU Treaty
Higher FFAEM
Specialist
RITA: Orange guide to training (SpR) Training
5 years
Regional Recruitment
General
Professional MRCP, MRCS and
Local Recruitment (SHO) Training MCEM
3-5 years
Pre-registration year
EoE 1995-97
• 24 hr CT/Image
transfer
• All ventilated pts
transferred NCCU
• Evacuation
Heamatomas <4hrs
BAEM: ‘Way Ahead’ Reports
• Medical staffing
• Workloads
• Interfaces : GP, specialties
• Recommended minimum
staffing levels
• Consultant JP
• Training
• CDU/Observation wards
Modernisation of A&E Depts 2000
• New Government 1997: Same spending plans
• Winters 1998 +1999 critical: Long A&E waits
• Modernisation Public Services: NHS Plan: 2000
• Increase NHS Budget GDP 6% to 8%
• Modernisation Agency: NSFs, NICE, Networks
• MMC-Modernisation of Medical Careers 2007
UK medical graduates 50 years
New Consultant and GP contracts 2003
2005-07 MMC
Senior
Senior Medical
Medical Appointments
Appointments
Career
Specialist and GP training programmes posts
(Run-through training)
Foundation training in
foundation schools
F2
F1
Undergraduate medical training
in medical school
Arrows indicate competitive entry
Medical school – 4-6 years
FCEM
ST4,
ST5,
ST6
ST6
Emergency Medicine
ST5
ST4
MCEM
ST3
ST3 EM trauma & musculoskeletal or T&O
ST2
EM Paediatrics + Paediatric EM
ST1
ACCS
ST2 1 year Anaesthetic + ICU
ST1 1 year EM + AM
FY2 2+6 = 8
FY1
Un-coupled EM CCT training 2008
ACCS
CT2 1 year Anaesthetics + ICU 6/12 each or 9/3 Core Training 3 yrs
CT1 1 year EM + AM 6/12 each
FY2
Foundation Training
FY1
70 Acute Med
Other
60
50
Percentage
40
30
20
10
0
2007 2008 2009 2010
EoE: ST4 Recruitment 2010
• “Ithaka” by CP Cavafy
• As you set out for Ithaka
hope the voyage is a long one,
full of adventure, full of discovery.
Laistrygonians and Cyclops,
angry Poseidon—don’t be afraid of them:
you’ll never find things like that on your way….