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Applying for Specialty Training

Applying for Specialty Training

Information for applicants applying for Specialty Training.

National recruitment to UK Emergency Medicine specialty training – information for applicants

National recruitment to UK Emergency Medicine specialty training is delivered by Health Education England (HEE) via Lead HEE Local Offices, supported by the EM Heads of Schools who sit on the RCEM Training Standards Committee. The lead recruiter for ACCS is HEE London and Kent, Surrey and Sussex (LaKSS) and DRE-EM, ST3 and ST4 recruitment is supported by HEE Yorkshire and the Humber (YHD).

Information on eligibility criteria, recruitment timelines, the application process, shortlisting, interviews and selection process can be found on Health Education England’s Medical Specialty Recruitment website. Here you will also find information on competition ratios, fill rates from previous recruitment rounds, Inter-Deanery Transfers (IDTs) and special circumstances.

Access here for Guidance for overseas applicants.

Person Specifications

Person specifications for those applying for ACCS, CT/ST3, DRE-EM (ST3), or higher specialty training (ST4-6) in Emergency Medicine are available. Applicants should refer to these person specifications when deciding which entry level to apply for.

ACCS Emergency Medicine Specialty Training Recruitment (2023 entry)

The lead recruiter for ACCS specialty training is HEE London and Kent, Surrey and Sussex (LaKSS). For further information and contact details, please visit the HEE website.

Training programmes: CT1 (Core) or ST1 (Run-through)

Recruitment to ACCS Emergency Medicine in 2023 will be offered as a core (CT1) or run-through option (ST1).

Run-through training: with run-through training, applicants are recruited for the full duration of the specialty training programme. Progression is uninterrupted, with applicants starting in specialty training year 1 (ST1), and progressing through ST2, ST3, ST4, ST5 and ST6 automatically, provided the necessary curriculum requirements are fully satisfied. These requirements include satisfactory ARCP outcomes and exam progression.  Although run-through training is uninterrupted, there are still plenty of opportunities on a run-through training programme to take time out to fulfil your broader interests. OOPs (out of training programme opportunities) are widely supported in all EM training programmes.

Uncoupled (Core) training: with uncoupled training, applicants are recruited to core specialty training (CT1-CT3). To progress to higher specialty training, trainees must subsequently enter a second stage of competitive recruitment following the first two or three years of core training.

Uncoupled (Core) and Run-through training each give opportunities to the individual trainee. The content of the training programme and its delivery are the same.

Following acceptance of an offer, successful applicants will be given one further opportunity to finalise their training route choice (further guidance on the process of confirming this will be included in the programme offer letter).

Please note, once you commence your training post, it will not be possible to change your training pathway from Core (uncoupled) to Run-through or vice versa. Therefore, it is recommended that decisions regarding the type of training programme to opt for are made after careful thought and consideration, including a recommendation to discuss opportunities with colleagues, mentors or local programme directors.

MSRA (Multi-Speciality Recruitment Assessment)

The MSRA (Multi-Speciality Recruitment Assessment) (40% weighting) and Virtual Interview (60% weighting) option will be used again for the coming year’s ACCS recruitment as this has been considered the best option for recruitment (interviews have been virtual for the past two years, as stipulated by the Medical and Dental Recruitment Selection Committee (MDRS) in October 2020). Longlisted trainees will sit the MSRA as a shortlisting tool for interview.

What is the MSRA?

The MSRA is a computer-based assessment, delivered in partnership with Work Psychology Group and Pearson VUE, which has been designed to assess some of the 6 essential competences outlined in the Person Specification and is based around clinical scenarios. It is delivered by Pearson VUE at assessment centres or, for applicants impacted by coronavirus, remotely using OnVUE (Pearson VUE’s online proctoring service). The MSRA contains two elements: a Clinical Problem Solving (CPS) test (75 minutes) and a Situational Judgement test called Professional Dilemmas (95 minutes), both of which are aimed at Foundation level and are suitable for ACCS recruitment. Other specialties to have used MSRA have been Primary Care, Clinical Radiology, Obstetrics and Gynaecology. Applicants are advised to prepare by reading widely and using situational judgement tests aimed at Foundation level trainees.

Work Psychology Group has analysed data from previous trainees who undertook MSRA for other specialty entry and were subsequently interviewed. The results have shown they performed well at interview. Therefore, there is a clear correlation of the MSRA score to support the application and recruitment process.

What MSRA resources are available?

HEE will be releasing some generic MSRA resources for applicants. Here are the School of GP resources .

2023 ACCS Recruitment Process

Please see the HEE medical specialty recruitment page and further information on ACCS-specific recruitment .

The application window will be open from Thursday 3 November 2022 until 4pm, Thursday 1 December 2022.

  • The person specification and application process remain the same as previously.
  • The score weighting remains the same as for 2021 (MSRA 40%, interview 60% of the total score) and candidates will be ranked nationally.
  • Interviews for August 2023 training start date will take place between 16 – 28 February 2023 and will be conducted virtually via MS Teams.
  • If you are invited to attend an interview, you will need to book an interview time slot in Oriel. Slots will be offered on a first come first served basis and will need to be booked by the deadline stated in the interview invitation.

What is the structure of the interview?

The interview will be 30 minutes and will be divided into two components: a 20-minute ‘face-to-face’ interview with 2 panel members via Microsoft Teams, and 10 minutes for the panel to cross-reference the submitted application to complete scoring. Only one of the two panellists will ask questions; however, both will be scoring. The interview capacity for 2023 will remain the same as 2022, with 840 trainees being interviewed.

Evaluation of outputs from both the MSRA and interviews will be conducted towards improving future ACCS EM recruitment.

RCEM Executive and RCEM Training Standards Committee (TSC) will continue to review the findings of evaluations undertaken following recruitment, including longitudinal assessments of candidates’ progress through training after appointment.

ACCS EM recruitment timeline

  • Application window: 3 November – 4pm, 1 December 2022
  • MSRA testing window: 5 – 17 January 2023
  • Interviews: 16 – 28 February 2023

ACCS Emergency Medicine (Northern Ireland)

Northern Ireland Medical and Dental training Agency (NIMDTA) manages recruitment to ST1 ACCS EM specialty training posts in Northern Ireland. For further information, please visit the NIMDTA specialty recruitment website.

Please note the following:

  • Shortlisting will be via self-assessment, and there is an interview capacity of 40 for 12 posts.
  • Interviews will take place via Zoom
  • Flexibility in Deployment of Trainees is applicable only to England, Scotland and Wales. Northern Ireland has separate arrangements for management of requests for Special Circumstances. Further information is available via email to
  • Facilitated Placements will not take place in Northern Ireland for August 2023 in any specialty process.

ST3 Defined Route of Entry into EM (DRE-EM) and ST4 Emergency Medicine Specialty Training Recruitment (2023)

The lead recruiter for ST3 DRE-EM and ST4 EM specialty training is HEE Yorkshire and Humber.

See here for further information on ST3 DRE-EM recruitment and the HEE EM ST3 DRE-EM National Recruitment 2023 applicant handbook.

See here for further information on ST4 EM recruitment and the HEE EM ST4 National Recruitment 2023 applicant handbook.

General information about applying to specialty training posts is available on the HEE medical specialty recruitment website.

Please note: There is now a separate application process for ST3 ACCS Emergency Medicine. If you wish to apply for this route of entry only, please apply to the ST3 ACCS Emergency Medicine vacancy on Oriel. Applications cannot be transferred so please ensure you are submitting the correct application.

Recruitment Process

The application window will be open from 10am, Thursday 17 November 2022 until 4pm, Thursday 8 December 2022.

  • The application process includes a number of multiple-choice self-assessment questions. A copy of the self-assessment form is included as appendix 3 in the applicant handbook.
  • Applicants will be shortlisted using their validated Self-Assessment score with the highest scoring applicants being invited to attend an interview
  • If you are invited to attend an interview, you will need to book an interview time slot in Oriel. Slots will be offered on a first come first served basis and will need to be booked by the deadline stated in the interview invitation.
  • Interviews will take place online between 15 – 17 March 2023.

What is the structure of the interview?

The interview will consist of 3 stations, designed to assess the selection criteria detailed on the 2023 Person Specification. The interview will be split into three 10-minute sections:

  • Prioritisation
  • Ethical/Clinical
  • Communication

Your performance in each domain will be scored using a structured scoring system. The scores from each interview station will be combined to produce your overall interview score. Your ranking will be based upon your overall interview score and your individual station scores.

ST3 DRE-EM and ST4 recruitment timeline

  • Applications open: 10am, Thursday 17 November 2022
  • Application deadline: 4pm, Thursday 8 December 2022
  • Interviews:15 – 17 March 2023

Accreditation of Transferable Competences (ATC)

The Royal College of Emergency Medicine has employed the Accreditation of Transferable Competences Framework (ATCF) to allow trainees entering Emergency Medicine training from GMC approved training programmes in ACCS (Anaesthesia), ACCS (General Internal Medicine – GIM), ACCS (ICM), Core Medical Training (CMT), Core Surgical Training (CST), Core Anaesthesia Training (CAT) and GP training to have some of the competences they have acquired in these programmes transferred into their EM training. The table below gives an idea of how much time could be counted in each instance.

1st CCT Programme Transferring to: Completed component Expected counted time Maximum counted time
ACCS [Anaesthetics] [GIM] [ICM] ACCS [EM] Anaesthetics, GIM, ICM, EM Time taken for each completed component 24 months
Core Anaesthetics ACCS EM Introduction to Anaesthesia 6 months 6 months
Core Anaesthetics ACCS EM ICM 3-6 months 3-6 months
CMT ACCS EM Medicine 6 months 6 months
CMT ACCS EM ICM 3-6 months 3-6 months
CST ACCS EM ICM 3 months 3 months
GP ACCS EM EM, AM Time taken for each completed component up to a maximum of 4 months each 8 months

These transferable components will normally be recognised for a CCT but trainees contemplating transferring to Emergency Medicine should contact the RCEM Training Department for advice.

Training falling within ATCF will be assessed during recruitment and then during enrolment when the College will calculate the trainee’s CCT date. Entry level will depend on the person specification for each year. Trainees must provide ARCP outcome 1s for all relevant periods of training as evidence of successful completion. The College has produced guidance for those applying and an application form.

The appropriate reduction in assessments will be made consistent with the proportion of specific competences recognised and reduction in training time.

NB: It is mandatory that a trainee must have successfully completed at least one whole time equivalent year in their first specialty before elements of their training can be recognised under the ATCF upon entry into the new specialty.


Applicants should be aware of the differences between CCT and CESR-CP. The GMC defines CCT:

“A CCT confirms that a doctor has completed an approved training programme in the UK and is eligible for entry onto the GP Register or the Specialist Register. The GMC have approved and quality assured the training programmes that eligible CCT applicants have completed. Trainees who achieve all programme competences in approved posts can apply for entry onto the specialist or GP register via a Certificate of Completion of Training (CCT).”

The GMC defines CESR-CP:

“However, some trainees who decide to join an approved specialist training programme have previously trained in other, non-approved posts. Your LETB/deanery and college/faculty may decide that this has already given you some of the CCT curriculum competences. If so, you can enter training at a later starting point, complete the rest of the programme and gain the remaining competences. This is known as the ‘combined programme’, at the end of it you can apply for entry onto the Specialist Register via a CESR (CP). Within the UK, there’s no difference in the recognition of a CESR and a CCT. Both certificates allow specialist registration on exactly the same terms. And specialist registration in any specialty means you can be appointed to a substantive consultant post in the UK health services.”

Applicants wishing to have non-GMC approved training counted towards core training (ST/CT1 to ST/CT3) should produce evidence at levels 1 and 2 in this form at recruitment interview.

RTT vs Core Training

NB: Applicants for posts beginning in August 2019 have until 30 April 2019 to change their mind about their choice of RTT or Core. Changing after this date will not be possible. Applicants are advised to think carefully about their choice as switching from one pathway to another (normally enquiries are from Core trainees wishing to switch to RTT) will also not be possible once they are trainees. If in doubt, applicants should choose RTT.

After you have accepted an offer for an ACCS EM training programme you will be asked to decide whether you wish to sign up for Run Through training (RTT) or a core training programme (CT).

Trainees on RTT begin at ST1 and continue, dependent on satisfactory ARCPs, to ST6 without the need to re-apply for HST (ST4-6). If you wish to apply for out-of- programme from your rotation this can be arranged with your HE Region/Deanery. If you wish to move to another HE region/Deanery during your training programme, there is an inter-deanery transfer (IDT) process that operates across the UK. If you do not fulfil the criteria for IDT you can apply via national recruitment and opt for the HE region/Deanery you wish to move to if there are posts available in recruitment and you are successful in the interview process. You will need to resign your RTT post if you decide to do this. Please take advice from your Head of School to ensure you give adequate notice. If you wish to change specialty, you can resign from the training programme and apply for a different speciality training programme.

Core Trainees will complete the first three years of specialty training in preparation for entering Higher Specialty Training. Although you will not be issued with a National Training Number (NTN) on appointment, you will be completing the first part of the EM GMC approved training programme and be subject to the ARCP process in the same way as those who do have a training number. You will be required to apply via the competitive national recruitment process for ST4 entry once you have successfully completed the core training programme.

Emergency Medicine Run Through Training (RTT) and Defined Route of Entry to Emergency Medicine (DRE-EM) programmes

Following successful pilots, the GMC have approved the Emergency Medicine Run Through Training (RTT) and Defined Route of Entry to Emergency Medicine (DRE-EM) programmes on a permanent basis with effect from 31 July 2017.

Run Through Training (RTT)

As described above, successful applicants to EM ACCS training posts can choose whether or not to enter an RTT post.

Defined Route of Entry to Emergency Medicine (DRE-EM)

DRE-EM is an entry point to ST3 for trainees who have a background in Core Surgical Training or a background in non-training posts in Emergency Depts. More details about entry requirements can be found in the table on page two of the ST3/DRE-EM person spec.

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