‍ACCS: Definition and Structure

ACCS is a two-year core 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. It is an alternative core training programme for trainees wishing to enter higher specialty training in Internal Medicine (IM) or Anaesthetics. It delivers all elements of the specialty-specific core training curricula, with additional augmented outcomes, i.e. capabilities beyond those areas covered by Stage 1 training in IM or Anaesthesia. The two years are spent rotating through six-month placements in Emergency Medicine (EM), Internal Medicine(IM), Anaesthetics and Intensive Care Medicine (ICM).

Specialty Specific Objectives for ACCS training

Emergency Medicine:

ACCS constitutes the first two years of the CCTin EM in a pre-planned and structured manner. ACCS training is then followed bya year in Intermediate training further developing clinical capabilities in adult EM (including musculoskeletal emergencies) and Paediatric Emergency Medicine as well as generic capabilities. Achievement of the requisite degree of independence by the end of Intermediate training – a key milestone point –confers eligibility for trainees to progress to Higher training in EM.

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Acute Internal Medicine:

ACCS is one of the training options available for delivering the core competencies required for a CCT in IM or one of the JRCPTB specialties in a pre-planned and structured manner. The two core years of ACCS training are followed by a further two years in acute medical specialties. Achievement of the requisite degree of independence by the end of this Stage 1 training – a key milestone point – confers eligibility for trainees to progress to Stage 2 training in IM and the specialties managed by the JRCPTB.

Anaesthetics:

Anaesthetics offers career opportunities in awide range of subspecialty areas, all of which can be achieved by direct entryto an Anaesthetic CCT programme. For those Anaesthetic trainees with an interest in the ‘acute’ end of the spectrum, ACCS provides a more widely-based experience than is available via the Core Anaesthesia programme. The two core years of ACCS training are followed by a further two years of Anaesthetic experience. Achievement of the requisite degree of independence by the end of this Stage 1 training – akey milestone point – confers eligibility for trainees to progress to Stage 2 training in Anaesthetics.

The Anaesthetics exit ACCS Trainees use the Lifelong Learning platform ePortfolio - the Wessex trainees have created a useful 'how to' guide which can be accessed here

Intensive Care Medicine:

ACCS allows trainees who wish to obtain the single CCT in ICM or a dual CCT in Internal Medicine& ICM, Anaesthetics & ICM or Emergency Medicine & ICM, to obtain the competences of the complementary specialties in a pre-planned and structured manner.

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ACCS in Wessex

ACCS training in NHS England South East (Wessex) takes place at five trusts:

• Portsmouth Hospitals University NHS Trust
• University Hospitals Southampton NHSFT
• Hampshire Hospitals NHSFT (Basingstoke)
• Salisbury NHSFT
• University Hospitals Dorset NHSFT (Poole)

The programme sits within the governance structure of the School of Emergency Medicine at HEE South East (Wessex).Trainees on appointment are informed which trust they will commence training in, and generally will be based in one trust for the first two years of the programme.

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ST3 is a pivotal year in your Emergency Medicine Training when you transition from being an SHO into a Registrar. It is the first year of your training where you will spend the whole year in an Emergency Department with a focus on Paediatric Emergency Medicine and developing your Leadership skills.

The year is split into two 6 month blocks – six months of Paediatric Emergency Medicine and six months of Adult Emergency Medicine.

There are twelve Regional Training Days some of which incorporate well known and useful courses, the rest are split between the 2 training sites. They aim to cover much of the clinical knowledge, clinical skill/procedures, and management items that are in your curriculum as well as developing skills to ensure your wellbeing.

There are currently two training sites for ST3:

- Portsmouth Hospitals University NHS Trust

- University Hospitals Southampton NHSFT

The programme sits within the governance structure of the School of Emergency Medicine at HEE South East (Wessex)

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Introducing the Wessex Emergency Medicine Trainees Association, known as WREMTA, a dynamic venture that emerged several years ago. Its core aim was to establish an exclusive platform for trainees, granting them easy access to invaluable training resources, the ability to organise training days, extend mutual support, and cultivate a sense of camaraderie within their group.

One of the remarkable attributes of WREMTA is its pivotal role as a communication conduit, facilitating engagement for Wessex trainees not only with our Training Programme Director but also with local course providers and training facilitators. Upholding an unwavering dedication to enhancing training experiences, WREMTA's strategic approach involves the meticulous design and coordination of regional training days, thoughtfully aligned with the latest RCEM curriculum. Collaborative partnerships with local Specialty College Tutors and HST educational leaders across the six Wessex Trusts, collectively comprising the Wessex EM Training Programme, further elevate the calibre of these initiatives.

Predominantly centred around in-person training sessions, a total of 15 training days are typically available throughout the year. These sessions are strategically arranged to offer immersive experiences, emphasising simulated scenarios and procedural expertise. Collaborating closely with the Training Programme Director, the trainee representatives curate these training days to align with the SLOs outlined in the RCEM curriculum.

WREMTA takes comprehensive measures to equip trainees for their final FRCEM exams, encompassing an annual MOCK FRCEM examination encompassing SBA papers and OSCE stations. This approach ensures a robust regimen for exam readiness.

A vital pillar of WREMTA's role is its provision of an ongoing discussion platform, solely dedicated to addressing pertinent training concerns on training days. It diligently gathers insights from diverse training sites, subsequently presenting these findings thrice a year to the TPD/school board, driving a continuous enhancement of the training provided.

In close partnership with SimWessex's esteemed faculty, WREMTA harnesses its affiliations to provide a range of courses covering Airway Management, Procedural Sedation for adults and children, and a variety of Emergency Procedures.

Efficient collaboration with the Deanery's USS lead, QIP, and EM Leaders faculty stands as a testament to WREMTA's commitment to meeting all prescribed training requirements. Currently overseen by two dedicated representatives, WREMTA takes pride in representing Wessex on the  EMTA Emergency Medicine forum.

Trainee Reps

Abigail Stokes & Anoopkishore Chidambaram