2010 Curriculum
>> 2010 ACCS manual / curriculum
ACCS training is described under the headings of 'common competencies', 'major and acute clinical presentations' and 'practical procedures' which cover the syllabus for acute medicine, emergency medicine and ICM. There is a separate section covering 'anaesthesia within ACCS' as well as a section covering additional areas for 'intensive care medicine within ACCS'. For each section a list of required assessments is described. More information on assessments in each of the four specialities can be found in the 'Assessments' section of this website.
25 Common competencies
These are competencies that should be acquired by all doctors during their training period starting within the undergraduate career and developed throughout postgraduate training. For ACCS trainees competence to at least level 2 descriptors will be expected prior to progression into further specialty training. Further assessment will be undertaken as outlined by the various workplace-based assessments listed within the curriculum. Common competencies include: history taking; clinical examination; safe prescribing; time management; decision making and clinical reasoning; patient as central focus of care; patient safety; valid consent; communication; evidence based medicine; audit and teaching.
6 Major Presentations:
All 6 major presentations are to be completed by the end of the first two years of ACCS training. These are: anaphylaxis; cardio-respiratory arrest; major trauma; the septic patient; the shocked patient; and the unconscious Patient.
38 Acute Presentations:
A minimum of 20 of the acute presentations must be covered during the first two years of ACCS training. These include the acute abdomen; acute back pain; breathlessness; collapse; chest pain etc.
44 Practical Procedures:
39 of the 44 practical procedures need to be completed throughout the first two years of ACCS training. The following document contains a matrix of the specific assessments required within each speciality module.
Anaesthesia in ACCS:
All ACCS trainees must complete the following sections of this section of the ACCS curriculum as a minimum and attain all the identified minimum clinical learning outcomes:
- i. Initial assessment of competence (IAC): must be completed within the first three months of anaesthesia and prior to being able to work without direct supervision. The IAC for ACCS differs slightly from that for pure anaesthesia trainees - more information can be found in the assessment pages.
- ii. Further modules:
- A. Basis of anaesthetic practice
- 1. Preoperative assessment
- a. History taking
- b. Clinical examination
- c. Specific anaesthetic evaluation
- 2. Premedication
- 3. Induction of general anaesthesia
- 4. Intra-operative care
- 5. Postoperative and recovery room care
- B. Airway management
- C. Critical incidents
- D. The paediatric anaesthetic competences listed for ACCS
| ACCS IAC checklist |
It is recognised that this is a challenging list of competences for the few trainees whose programme includes just 3 months of anaesthetics; in this instance, it is essential that they are given as much time out of their Intensive care medicine training as required (which will last nine months for such trainees) to ensure they achieve these essential competences which are core to patient safety. For trainees who complete the ‘usual’ six months of anaesthetic training in a two year ACCS programme, a minimum of one of the additional elements of training listed below must be completed successfully (which, will depend upon trainee interest and local availability):
- Introduction of anaesthesia for emergency surgery
- Transfer medicine
- Sedation
- Aspects of regional anaesthesia
For those trainees whose programme of training includes nine months of anaesthesia, the competences in all the additional areas of practice identified above should be attained for successful completion of their anaesthetics ACCS training.
Intensive Care Medicine for ACCS:
Alongside covering the relevant common competencies, acute / major presentations and practical procedures while in ACCS, a trainee must cover the following speciality specific curriculum for ICM while in ACCS:
- (i) Demonstrates aseptic peripheral venous cannulation
- (ii) Demonstrates aseptic arterial cannulation
- (iii) Obtains an arterial blood gas sample safely, interprets results correctly
- (iv) Demonstrates aseptic placement of central venous catheter
- (v) Connects mechanical ventilator and selects initial settings
- (vi) Describes Safe Use of Drugs to Facilitate Mechanical Ventilation
- (vii) Describes Principles of Monitoring Respiratory Function
- (viii) Describes the Assessment of the patient with poor compliance during Ventilatory Support (‘fighting the ventilator’)
- (ix) Prescribes safe use of vasoactive drugs and electrolytes
- (x) Delivers a fluid challenge safely to an acutely unwell patient
- (xi) Describes actions required for accidental displacement of tracheal tube or tracheostomy
It is expected that all ACCS trainees will achieve Basic Level Competence as outlined by IBTICM during ACCS training. Used alongside the rest of the ACCS Curriculum, these ICM specialty specific competencies are designed to inform the IBTICM Basic Level Training Competency Document (Part 3). Assessment should be made using the work place based assessment tools described, as part of the overall process used to complete this documentation. A trainee completing more than three months of ICM arew encouraged to complete some of the intermediate IBTICM competencies also.
Further information on the intensive care curriculum can be found on the IBTICM website.
Each area is described in terms of: the subject area; the required knowledge; the required skills; and the required attitudes and behaviour. Each area also has a range of possible assessment methods that could be used to show a trainees competence in that area, and all areas are mapped to the GMC's Good Medical Practice headings.