The last year of ACCS Emergency Medicine is probably the most challenging but the most enjoyable year. This is really the time that you have been waiting for so long to get properly stuck into Emergency Medicine. It is split between 6 months of Emergency Medicine and 6 months of Paediatric Emergency Medicine placements, in no particular order, across Yorkshire and Humber.
You will start to lead the trauma team and get more understanding of it, assess and manage minor injuries including manipulation and reducing joints as well as casting and the like, performing procedural sedation either for emergency cardioversion or dislocation/fractures, learning and practicing ultrasonography scan level 1 such as AAA/Echo in life support/eFAST/peripheral and central venous access, getting more confidence in seeing and assessing paediatric patients, start thinking about the quality improvement projects you might want to perform in the department as well as the critical appraisal skills with the FRCEM final exam in mind whilst completing the intermediate exam, and finally getting all the ACCS competencies signed off before the ARCP.
As always it is expected that the RCEM e-portfolio is kept up-to-date with appropriate supervisor meetings, assessments, personal professional development and the like. In order to make sure that you have all the requirements for passing the end of the year ARCP, there is a very helpful check-list outlined by the deanery.
Once this year is done and dusted, you could look towards the light at the end of the tunnel as you venture into the Higher Speciality Training in ST4, or perhaps out of programme experience such as sim fellowship or future leadership programme, and to develop sub-speciality interests.
Mr Nick Mani ST3 EM Trainee in South Yorkshire and Humber Deanery
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