2007 Curriculum


>> 2007 ACCS manual / curriculum


ACCS training comprises four modules, GIM (Acute) (ACCS manual Appendix C), anaesthesia (ACCS manual Appendix D), emergency medicine (ACCS manual Appendix E) and ICM (ACCS manual Appendix F), each of which is composed of units of training, some of which are compulsory, others are optional. The units cater for general and specialist clinical areas as well as generic non-clinical subjects. Each unit is described in terms of:

  • the subject area;
  • the required knowledge;
  • the required skills;
  • the required attitudes and behaviour;
  • workplace training objectives for the trainee;
  • and for some specialist areas, the training environment

Your ACCS portfolio, including logbook and work place assessments, should allow you to demonstrate competence in all of the curricula which will be required to successfully complete the ACCS programme. Please refer to the specific home pages for more information on the portfolios for each module.


Acute Medicine Curriculum

Trainees are expected to acquire Level 1 competencies in both the general internal medicine (Acute Medicine) and the generic curricula and should demonstrate these competencies with a combination of assessments and tools from the e-portfolio.

>> General Internal Medicine (Acute Medicine) [GIM(AM)] Curriculum

>> Generic Medical Curriculum

Acquisition of level 1 competences should be pursued by all ACCS trainees but it is recognized that this may not always be achieved especially when the trainees primary specialty is not acute medicine. For all acute medicine trainees acquisition of level 1 competences is very important for career progression. If you are in any doubt about this aspect of your training please discuss with your educational supervisor or regional programme director. This section lists the specific knowledge, skills, attitudes and behaviours to be attained when training in Acute Medicine. The competencies for the GIM(AM) curriculum are presented in four parts:

  • Part 2.1 - Symptom Competencies - define the knowledge, skills and attitudes required to level 1 of the General Internal Medicine (Acute) curriculum. These symptom competencies are broken down into emergency presentations, top 20 presentations and other presentations. The top 20 presentations are listed together to emphasise the frequency with which these problems are encountered in clinical practice and are based on medical admission unit audit data.
  • Part 2.2 - System specific competencies – The knowledge associated with the development would be expected to be known by all trainees planning a career in Acute Medicine. For all other trainees in the ACCS programme knowledge of these system specific competencies and, in particular, the basic science associated with these conditions would not be expected to be so extensive.
  • Part 2.3 - Investigation competencies - lists investigations that a trainee must be able to describe, order, and interpret by the end of ACCS.
  • Part 2.4 – Procedural competencies - lists procedures that a trainee will be competent in by the end of ACCS.

The generic curriculum sets out a sound professional, moral and legal framework for practice, as described by the GMC’s Good Medical Practice.


Emergency Medicine Curriculum

The emergency medicine curriculum provides a framework from ST1/CT1 till completion of training at CCT level. The curriculum not only indicates the skills and knowledge needed but the types of learning opportunities and the assessment methods - including workplace based assessment. The curriculum is highlighted with colours to identify competencies expected by certain levels of training. All ACCS (EM) trainees must have completed the sections in black text by the end of their ST2/CT2 training though many of these competencies may be covered in the complementary specialities of ACCS. Those competencies expected at the end of ST3 (after Paediatric and Orthopaedic training) are indicated in blue and at the end of ST5 (after a further 2 years of training in Emergency Medicine) are indicated in red.

>> Emergency Medicine Curriculum

ST3 will comprise at least 6 months of Paediatric EM and either 6 months in Trauma and orthopaedics, or in EM with protected training time to gain competencies in musculoskeletal trauma. The latter post would allow the trainee to for example receive training in fracture clinics, hand surgery lists and by following multiply injured patients from the ED for the first 4 to 6 hours of their inpatient/operative care. ST4 to 6 are spent receiving incrementally more advanced clinical, academic and managerial training in the Emergency Department. Up to 6 months of this may be spent working outside the ED gaining additional competencies for example in neurosurgical or radiological assessment of patients. This is at the discretion of the training supervisor and PG Deanery, based on individual training requirements. The arrangement of this optional out of department training will vary between Deaneries.


Anaesthesia Curriculum

Note: the Anaesthesia Portfolio can be found on the 'Anaesthesia Home Page' along the top menu bar

While in Anaesthesia, ACCS trainees should follow the relevant section of the ACCS curriculum, found on pages 119 - 156.

>> ACCS curriculum

Trainees in Anaesthesia are expected to pass the Initial Assessment of Competence (IAC) after approximately 3 months of training. ACCS trainees doing more than 3 months training in anaesthesia will follow a syllabus defined by Sections 4 to 6, 9, 14 and 16 to 21 of The CCT in Anaesthesia (part II: Basic Level (for ST / CT years 1 and 2) Training and Assessment).

The following documents contain the Anaesthesia basic level curriculum and supporting documents in full, though note these are in greater detail than is required for ACCS alone.

Anaesthesia Curriculum


Intensive Care Curriculum

The curriculum for ICM ('CCT in Intensive Care Medicine') is defined by the Intercollegiate Board for Training in Intensive Care Medicine (IBTICM) and is competency based, the documents for which can be found below. The CCT curriculum is divided into Basic (3 months at ST 1/2 level), Intermediate (6 months normally at ST3 or above) and Advanced (12 months at ST4/5 or above) levels and on successful completion allows application for the joint CCT.

The curriculum for ACCS trainees in ICM is divided into a preliminary syllabus (basic level competencies) for use over the initial three months of ICM training. ACCS trainees completing more than three months in ICM will also complete the core syllabus competencies (covering part of the intermediate curriculum). However the IBTICM and national ACCS committee have stated that trainees will need to complete further ICM training at intermediate level (ST3 and above) in order to gain Intermediate ICM accreditation.

The curriculum for training in adult ICM is categorised in domains, each of which is presented as Knowledge, Skills, Attitudes and behaviour, and Workplace training objectives, in addition to basic sciences. The acquisition of these competencies should be recorded in the educational training record during the module with formal assessment of competence required. The documentation for this can be found below. The generic work place assessments as required for completion of the ACCS programme are additional to the ICM competency documents and should be used to support development.

Preliminary (Basic) syllabus

Trainees will be expected to demonstrate a level of knowledge and skills which permit them to identify acutely ill patients, initiate appropriate emergency management, stabilise them for transfer, plan their care for the first hour in ICU, and identify serious complications which may arise during intensive care. The assessments will be conducted in the workplace, usually during the third month. The trainee will be assessed in the following:

  • CPR skills
  • Airway management
  • Initial assessment of competence in the management of the acutely ill patient
  • Organ support and practical procedures
  • Communication skills, clinical judgement, attitudes and behaviour

The clinical skills that are to be assessed must be supported by knowledge of the presentation, identification and management of common medical and surgical conditions which may result in critical illness. The focus is on first-point-of-contact, and the initial stabilisation of a sick patient. This will include knowledge of applied physiology and pharmacology, and an understanding of appropriate methods for basic organ system support and their potential complications.

Core (Intermediate) syllabus

The trainee will be assessed in the following areas:

  • Practical procedures, comfort care and organ system support
  • Patient management: assessment, investigation, monitoring and diagnosis
  • Outreach and Transport care
  • Communication Skills, Attitudes and Behaviour
  • Cardiopulmonary Resuscitation

Object: After completing Core training the trainee will be expected to have acquired the clinical ability to manage the majority of patients on a general intensive care unit and to recognise the need and appropriateness of intensive care admission and to manage safe transport of the patient. In these assessments, the trainee will be expected to support the demonstration of clinical skills with knowledge of the relevant areas as described in the syllabus. This will include establishing a safe environment for critically ill patients inside and outside the ICU, and one in which patient suffering is minimised by an humanitarian approach to patient care and the judicious use of drugs to relieve distress. The trainee should be able to develop clinical management plans for several hours of intensive care, and to modify those plans according to changes in the patient's condition. The trainee should be able to support junior or less experienced colleagues, and to prioritise work based on competing clinical needs.

Case Summaries: Core (Intermediate) syllabus

During Core Training it is a requirement that each trainee compiles ten case summaries. (See Part II, the Educational Training Record). The purpose of this exercise is to educate in the specific disease state and process described, to train in the arts of searching for information and writing medical text coherently, and to permit reflection on practice.

Intensive Care curriculum documents:



CCT requirements

See document from IBTICM (here) for information on CCT requirements for those wanting to apply for the Joint CCT with Intensive Care Medicine.



A trainee's guide is also available:

The relevant documents for ACCS trainees are contained in the ACCS curriculum pages 257-274.

>> ACCS curriculum



Website designed & created by Jess Briggs & Jonathan Goodall