ACCS is a 3 year training programme that normally follows Foundation Year 2. It is the only core training programme for trainees wishing to enter higher specialty training in Emergency Medicine and is an alternative core training programme for trainees wishing to enter higher specialty training in General Internal Medicine (GIM), Acute Internal Medicine (AIM) or Anaesthesia. The first two years are spent rotating through Emergency Medicine (EM), General Internal Medicine, Anaesthetics and Intensive Care Medicine (ICM). The third year is spent providing training that will ensure the trainee meets the minimum requirements for entry into higher specialty training in their parent specialty (EM, GIM/AIM, Anaesthetics and also ICM). The components of training in ACCS are:
- 1 year emergency medicine + general internal medicine: acute (usually 6 months each)
- 1 year anaesthesia + intensive care (minimum of 3 months in each)
- 1 further year within chosen parent speciality *
* For trainees beginning ACCS training from 2010. (Acute Medicine ACCS trainees starting prior to 2010 are likely to have been appointed to a two year training programme encompassing the first two years of ACCS only)
Aims of ACCS
The aim of ACCS training is to produce multi-competent junior doctors able to recognise and manage the sick patient and who have the complementary specialty training required for higher specialist training in emergency medicine, acute medicine, anaesthesia and intensive care medicine.
Within the overall aim, each parent specialty has a specific objective for their own ACCS trainees:
- Acute Medicine: ACCS is one of the training options available for delivering the core competences required for a CCT in GIM, AIM or one of the acute medical specialties in a pre-planned and structured manner. The first two years of ACCS training (GIM (Acute), EM, Anaesthetics and ICM) are followed by a further year in GIM (Acute). The trainee should take part in at least 4 shifts of acute medical take per month during the 6 month period of training in medicine. This three year training programme fulfils the requirements for progression to higher training in GIM, AIM or an acute medical specialty.
- Emergency Medicine: ACCS constitutes the first three years of the CCT in EM in a pre-planned and structured manner. The first two years of ACCS training (EM, GIM(Acute), Anaesthetics and ICM) are followed by a further year gaining additional competences in adult EM (including musculoskeletal emergencies) and Paediatric Emergency Medicine; thus fulfilling the requirements to progress to higher training in EM.
- Anaesthesia: Anaesthetics offers career opportunities in a wide range of subspecialty areas all of which can be achieved by direct entry to an Anaesthetic CCT programme. However, those Anaesthetic trainees with an interest in the ‘acute’ end of the Anaesthetic spectrum will find ACCS an ideal career starting point. It provides trainees with more widely based experience than is available solely within the Anaesthetic CCT programme. The first two years of ACCS training (GIM (Acute), EM, Anaesthetics and ICM) are followed by a year of Anaesthetic experience at CT2 level.
- Intensive Care Medicine: ACCS allows trainees who wish to obtain dual CCT in Acute Medicine & ICM, Anaesthetics & ICM or Emergency Medicine & ICM, to obtain the competences of the complementary specialties in a pre-planned and structured manner.
- ACCS and the academic trainee: Trainees joining the ACCS programme may wish to pursue an academic career and have the opportunity to compete for Academic training posts. This gives the successful trainee the opportunity to undertake an additional year of training specifically to prepare them for research. This will enable them to submit a research proposal which, if successful, will provide the funding to support their research before they enter higher specialist training. When this year is undertaken will be determined locally and will typically involve attendance at taught courses covering such areas as critical analysis of scientific literature, information management, study design, basic statistical analysis, fraud, ethics and plagiarism, presentation skills, scientific writing and publishing skills. Trainees may have the opportunity to complete a Masters programme in research. The three years of clinical training within the ACCS programme has to be completed by these trainees. The clinical component is demanding and experience has shown that trainees need all this time to gain the knowledge skills and attitudes required and to be successful in the summative assessments. The overall clinical training time for these trainees should not be shortened.
During the ACCS programme, you must complete a portfolio of evidence in support your achievement of the curriculum. As well as work place assessments this should include a clinical log book, a record of educational, management, audit and clinical governance activities, relevant continuing professional development activities and a written record of your supervisors meetings and personal development plan. Details of these can be found across the relevant webpage’s.