Recruitment to themed core specialties 2012
Anaesthesia, Emergency Medicine, Acute
Medicine & Intensive Care Medince
Aneasthesia CT1 and ACCS (Anaesthesia) CT1 will be recruited as
one process via the the West Midlands Deanery
This is a separate process from ACCS (Emergency
Medicine) and ACCS (Acute Medicine) and requires a separate
application using an Anaesthetic application
Applicants who wish to follow a career in Anaesthesia should
apply with a single application form for both Aneasthetics CT1 and
There will be one "guaranteed" interview at your first (or next
highest preference depending on interview capacity)
The application form will ask you to indicate whether you wish
to be considered for CT1 Anaesthesia and/or ACCS
(Anaesthesia). The West Midlands Deanery will request more
details on preference of programmes at a later date.
Following interview, places in programmes will be allocated
according to rank and expressed preference for programme.
Once a post in a Deanery is accepted (or held) there can be
automatic upgrade to a higher preference programme within
Anaesthesia/ACCS Anaesthesia should this become available.
ACCS (Emergency Medicine)
Applicants who wish to follow a career in Emergency Medicine
should apply for CT1 ACCS (EM) via the London Deanery.
This is a separate process from ACCS (Anaes) and ACCS
(Acute Medicine) and requires a separate application using an EM
All eligible applicants will be interview at a central
asssessment centre in London. The interviews will take place
the week beginning 23rd January 2012.
Preference for Unit of Application will be asked for at
application. Following interivew, places in programmes will
be allocated according to rank and expressed preference for
Once a post in Emergency Medicine is accepted (or held) there
can be automatic upgrade to a higher preference post within
Emergency Medicine should this become available.
ACCS (Acute Medicine)
Applicants who wish to follow a career in Acute Medicine of
acute medical specialties should apply for CT1 ACCS (AM) via the
Royal College of Physicians as part of Core Medical Trainingin
This is a separate process from ACCS (Anaes) and ACCS
(Emergency Medicine) and requires a separate application using the
combined CMT and Acute Medicine application form.
Candidates will be able to preference up to four deaneries and,
if eligible will be allocated to the highest choice Unit of
Application based on their application form. The window for
interviews is 24th January 17th February 2012.
Candidates will be able to preference from a combination of CMT
and ACCS-AM posts, and will be able to sub-preference CMT
programmes, ACCS-AM programmes, or any combination of the
two. Following interview, places in programmes will be
allocated according to rank and express preference for
Please note the following advice from the
Intercollegiate Committee ACCS Training
Recruitment to ACCS will be by separate streams, dependent on
intended parent specialty. The first two years of ACCS share a
common curriculum, and any competences acquired are
transferable. However, it is not possible to switch
between specialty career paths without a further competitive
selection process. Applicants are therefore advised
to select their initial specialty of choice with care.
Intensive Care Medicine (ST3)
In 2010 the Faculty of Intensive Care Medicine was tasked
by the General Medical Council of Intensive Care Medicine
was to develop a new standalone curriculum in Intensive Care
Medicine (ICM). This curriculum has now been approved by
the GMC. This curriculum will apply to trainees appointed
specifically to the standalone CCT in ICM for August 2012
The West Midlands Deanery will act as the co-ordinating Deanery
for recruitment. National Recruitment for ICM will be for
doctors starting in ST3 from August 2012 on the new
curriculum. For those appointed to ST3 before August 2012,
recruitment to the joint CCT will continue until July 2013 -
after this date there will be no further recruitment to the
joint CCT, but those trainees who have been appointed to it will
continue in it until completion. Trainees undertaking the
single CCT in ICM will be able to apply for dual CCTs in ICM and a
partner specialty for August 2013 onwards.
Single CCT Intensive Care Medicine
From August 2012 trainees will be able to
enter a standalone certificate of completion of training (CCT)
programme in intensive care medicine, after competitive entry at
specialty training year 3 (ST3) level. On their successful
completion, these programmes will lead to the award of a CCT in
intensive care medicine. Entry will be competitive, with national
selection and ranking in England and Wales using identical
processes to other current CCT programmes. Entry to higher
specialist training in intensive care medicine differs from most
other CCTs in that it deliberately does not have one single core
programme. The Faculty of Intensive Care Medicine, supported by its
constituent royal colleges and the GMC, wanted to see the
established multidisciplinary approach to intensive care medicine
Trainees applying for higher specialist
training in intensive care medicine can enter by any one of three
separate routes: Core Anaesthetic Training (CAT), Core Medical
Training (CMT), or any of the Acute Common Care Stem (ACCS)
strands. Successful candidates will then enter Intensive Care
Medicine at ST3 level with different training experiences and
competencies. For example, core medical trainees will have few or
no skills in anaesthesia, and core anaesthetic trainees will have
little experience in the assessment and management of severely ill
patients in medical admission wards. The first two years of higher
training in Intensive Care Medicine (ST3 and ST4) were designed to
allow an individualised programme of training so that all trainees
would achieve the same level of competency by the end of ST4. The
first four years of intensive care medicine training (CT1 to ST4)
are designated stage 1.
Stage 2 training occurs in ST5 and ST6, and the exact sequence
of attachments will vary from scheme to scheme. During these years
trainees will consolidate their general training in intensive care
medicine as well as develop specialist skills. Competencies will be
gained in the management of critically ill neurosurgical and
cardiothoracic patients. Experience in the management of severely
ill children will also be gained; however, the intensive care
medicine CCT programme is not aimed at providing advanced training
in paediatric intensive care medicine.
Stage 2 training also allows a period of acquisition of special
skills. This develops the multidisciplinary philosophy of intensive
care medicine training by allowing trainees to choose from various
modules. These are currently being developed but will include
training in advanced imaging techniques, research methodology, and
audit and quality improvement techniques. Some trainees may also
choose to enhance their specialist skills with further training in
cardiothoracic or neurosurgical intensive care medicine.
Stage 3 training (ST7) is designed to allow trainees to enhance
further their competencies in intensive care medicine, with an
emphasis on organisational, management, and quality aspects of the
While some trainees may want to follow a
career in Intensive Care Medicine only, many are likely to want to
pair this with a second CCT in Anaesthesia, Emergency Medicine, or
one of the medical specialties (Respiratory Medicine, for example).
In 2012, trainees in existing CCT programmes will still be able to
apply for the old joint CCT programme. In 2013 this will be
replaced by the new dual CCT programme. Trainees who wish to train
in both Intensive Care Medicine and a partner specialty will be
able to do this by a stepped entry method.
They will initially need to compete for their
first CCT post and then within 18 months to compete for their
second CCT post. For example, a trainee who enters an Intensive
Care Medicine CCT programme in August 2012 will have until February
2014 to enter a partner CCT programme. Alternatively, a trainee in
a partner CCT programme from August 2012 can, within 18 months,
apply for an Intensive Care Medicine CCT programme.
The total duration of training needed to
achieve dual CCT accreditation will, of necessity, be longer than
that for a single CCT. However, the Faculty of Intensive Care
Medicine, with the GMC, is identifying those competencies that can
be acquired in either part of a dual programme. It is therefore
likely that the total duration of dual training will not exceed 8.5
years in most cases.
A career in intensive care
No single attribute can define a successful
practitioner in intensive care medicine, but it is likely that most
consultants will have a preference for being a “complete physician”
in the sense that they have broad knowledge of many diseases and
treatments; possess advanced technical and non-technical skills in
physiological and emotional support of patients and their families;
have the capacity to integrate care across disciplines, locations,
and time; are simultaneously team players and team leaders; and
teach and inspire others by example. More specifically:
- They are interested in acute physiology and the way in which
human physiology can be manipulated to improve outcomes in severely
- They can rapidly assimilate and integrate large amounts of
complex data (including those from physical examination and history
- They can make rapid and decisive action plans in the face of
often considerable clinical uncertainty.
- They are able to both lead and contribute to truly
multidisciplinary clinical teams.
- They are good negotiators for their patients. Intensive care
medicine consultants will often have a role as care coordinator,
acting as an intermediary between clinical teams.
- They are comfortable with and skilled at performing practical
- They can “multitask” in situations that are often pressured in
terms of both time and work intensity.
- They accept that intensive care medicine work is unpredictable
and often occurs outside normal hours.
However, a career in intensive care medicine
is not just about immediate care. A good intensivist is also
interested in longer term problems, and many intensivists now
follow up their patients after discharge from the intensive care
unit. Effective practitioners are also good managers and are
interested in improving the quality of their service. Intensive
care medicine was one of the first specialties to organise
comprehensive national units, and this work continues to inform the
design and delivery of services.
These are good. In the first year it is likely
that more than 60 additional intensive care medicine CCT posts will
be released, bringing the total number to more than 200. This will
probably increase in future years to reflect the need for more
consultants in intensive care medicine