Sub-Specialty – Paediatric Emergency Medicine
Paediatric Emergency Medicine is a sub-specialty of both Emergency Medicine and Paediatrics. EM Trainees in the UK have the opportunity to apply for and, if successful, train in a sub-specialty training programme while retaining their NTN. When both parent specialty and sub-specialty training are completed successfully then the College will recommend to the GMC that the trainee be included on the specialist register with PEM as a sub-specialty.
Six months Paeds/PEM training is part of the EM curriculum during the CT/ST3 year. This six months training cannot count towards the twelve months training at sub-specialty level. This section of the website will be concerned with sub-specialty level PEM.
Subspecialty Paediatric Emergency Medicine training for Emergency Medicine doctors in training is an additional year of in-programme training which usually requires an extension of CCT date by 12 months, taking the indicative training time from 6 years to 7 years (whole time equivalent).
PEM posts are advertised regionally and there is a transparent competitive application process which complies with GMC subspecialty rules. This results in some trainees doing their PEM year in their home deanery and others doing their PEM year in another region. Both of these situations should be considered in-programme training, not out-of-programme.
It is expected that pay progression for doctors in training during subspecialty training would continue in line with total accumulated training time.
RCEM recommends that ‘Out-of-Programme’ should not be used as a shorthand way of describing a doctor in training doing their in-programme subspecialty PEM training in another region or ‘ST7’ as a description of an extra year of training unless it actually occurs following completion of the ST6 training year owing to the confusion that this may cause with pay progression.
PEM Trainee Handbook – A practical guide for trainees at any level, from initial interest to CCT
More Information on PEM
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Sub-specialty – Pre-Hospital Emergency Medicine
Pre-Hospital Emergency Medicine is a sub-specialty of Emergency Medicine. Trainees in Emergency Medicine can apply for PHEM training in their ST4 year. PHEM training programme places are available through national recruitment and consist of 12 months whole time equivalent training during ST5 year or above and including post-CCT. There are a small number of one-year pure PHEM posts nationally and the majority are blended training with a mix of EM/PHEM shifts (in total, one year of EM and one year of PHEM) over a two year Out of Programme Training (OOPT). Less than full time (LTFT) PHEM training is also available.
It is recommended that career advice is sought early for trainees who are interested in sub-specialty training in PHEM. Trainees can get more information from the IBTPHEM website  or by contacting the regional PHEM TPD for their region/neighbouring region or a representative from the PHEM Trainees Association.
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Dual Accreditation – Intensive Care Medicine
Intermediate and Advanced level accreditation in Intensive Care Medicine (ICM) is currently available for EM trainees as regulated by the Faculty of Intensive Care Medicine (FICM). This training is available on a competitive basis and leads to dual CCTs in ICM and EM but only when both training programmes have been completed. Not all programmes will be able to offer, or trainees able to pursue, dual accreditation. Training time is extended as guided by the FICM.
Once appointed to an ICM CCT post for the purposes of Dual accreditation, trainees must ensure that they are registered with the Faculty of Intensive Care Medicine. Any queries should be directed to contact@ficm.ac.uk. Trainees should also inform the RCEM so that CCT/CESR-CP date can be reviewed.
See the Guidance on Dual CCT Programmes in Intensive Care and Emergency Medicine. (2021 Update)
Further information can be found through the Faculty of Intensive Care Medicine at ficm.ac.uk.