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Applying for Specialty Training

Applying for Specialty Training

Information for applicants applying for Specialty Training.

Information for applicants to UK specialty training

HEE has a resource bank of information useful for applicants to UK specialty training. It contains documents relating to competition ratios, facilitated placements, Inter-Deanery Transfers (IDTs) and alternative certificates. HEE’s applicant guidance includes sections on all aspects of specialty recruitment including guidance for overseas doctors. Applicants will also find the user guide to the Oriel online portal helpful. An NHS Health Careers diagram outlining the EM training pathway is available here.

Person Specifications 2021

Person specifications for those applying for ACCS, CT/ST3 or DRE-EM (ST3) or higher specialty training (ST4-6) in Emergency Medicine starting in August 2021 are available here. Applicants should refer to these person specs when deciding what entry route to select. A document outlining SOP for eligibility queries is here: Eligibility query SOP.

NB. Applicants should be aware that HEE and not the College manage recruitment. This includes setting the interview dates which cannot be re-scheduled to accommodate personal circumstances (including pregnancy). Queries about interviews should be addressed to HE Yorks and Humber (ST3, DRE-EM ST3 and ST4) or LaSE (EM ACCS).

National 2021 EM ACCS Recruitment

The recruitment timeline has not yet been confirmed. Please continue to check on the LaSE website for further updates.

HE London and South East (LaSE) Recruitment Office oversees national EM recruitment to ACCS CT1/ST1 posts throughout England, Wales and Scotland. Contact information is available on their website here.

If you have questions concerning the recruitment process please contact Shared Services London via their web-based Applicant Enquiries Service.

National 2021 EM ST4 Recruitment

EM ST4 national recruitment is managed by the HE Yorks and Humber. More information is available on their website here.

National 2021 ST3 Defined Route of Entry into EM (DRE-EM) and EM ST3 Recruitment

HE Yorkshire and Humber oversee national EM recruitment to DRE-EM (ST3) and EM ST3. More information is available on their website here.

Posts in Northern Ireland are recruited locally in a separate process details of which can be found here. If you have questions concerning the recruitment process please contact

National Information

Further information on the application and recruitment process can be found on the national Medical Specialty Training websites:

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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