Careers in Emergency Medicine offer excitement, variety, challenge and reward. Doctors and practitioners working in Emergency Medicine use their clinical skills and experience to recognise and treat the full spectrum of emergencies in patients of all ages.
Doctors and practitioners working in Emergency Medicine use their clinical skills and experience to recognise and treat the full spectrum of emergencies in patients of all ages.
Being the first clinician to see a patient who is seriously ill or injured, gathering information and thinking on your feet is what working in Emergency Medicine is all about. You will use your core clinical skills to rapidly assess patients, work out what’s going on, and make quick decisions about what to do.
You will learn through training and experience how to deal with anything that comes your way. In the midst of a stressful or uncertain situation, you will remain calm whilst providing emergency treatment, reassurance and pain relief. You will see patients at their sickest and they will improve in front of you as a result of your care.
You will be part of a team of doctors, specialist nurses, practitioners and support staff focused on providing emergency care. Senior clinicians will work alongside you, providing training and support as you assess and manage patients together.
Working in the Emergency Department, at the centre of the acute hospital, Emergency Physicians work closely with other specialties to coordinate the initial phase of the patient’s journey. You will also be in regular contact with the emergency services, and you will work with allied health professionals and social care to provide a holistic approach to your patients’ needs.
The Emergency Department is open 24 hours a day, 365 days a year. It is where the public know to come if they need medical help. Every day you will interact with many different patients, relatives, carers, and other members of the public.
You never know what might come through the door. You will deal with everything from major trauma to social and psychiatric emergencies. One minute you might be reducing a dislocated shoulder, the next assessing a sick child. The breadth of clinical practice in Emergency Medicine means there is plenty of variety and the opportunity to specialise or focus on the aspects that you find most interesting.
Perhaps you have already decided that this exciting, varied and dynamic specialty is for you! Or maybe you are interested in finding out more. Whether you are fully committed or still undecided, there is plenty of information here to help make up your mind.
The Emergency Department is a great place to get experience, finely tune your clinical skills, and learn how to recognise the critically unwell patient.
It’s never too early to explore Emergency Medicine as a career. Spend as much time as possible in the Emergency Department, gaining experience in this environment. Many medical schools offer optional Emergency Medicine special study modules based in the department, which will give you an even better opportunity to see what it’s like.
The College run annual Careers events, either face to face or virtually, aimed at providing a real insight into life as an Emergency Physician. You will hear first hand accounts from doctors and practitioners at various different points in their careers. If you are looking for the inside story, plenty of information, and all of your questions answered then you’ve come to the right place!
As a student you can become an Associate Member of the College. This gives you access to the latest information and advice on training, and a wealth of educational resources such as e-learning modules and up to date guidelines, together with reduced price entry to College conferences and events.
Student Membership is £20 per year.
Many universities have student societies of Emergency Medicine, or societies focused on one of the main areas of our practice, such as Trauma. This is a great way to find out more about Emergency Medicine knowledge and skills and to speak to other people considering it as a career. Why not find out what is available locally?
The College has just launched an affiliation scheme in order to recognise and support the work of these societies and enable networking. As we develop our list of affiliated societies we’ll include links to them here.
There are plenty of ways to get more experience.
An elective in an Emergency Department at home or abroad would help to broaden your experience and demonstrate your commitment to the specialty. It’s useful to see how practice changes in different settings with their own unique challenges and there is always something new to learn.
Build on your emergency medicine knowledge by making the most of online resources. A great way to do this is to base your learning around cases you have seen. Much of what you learn will be useful in day to day practice.
Consider volunteering on a local first aid or life support course – this is a great way to get experience in resuscitation skills and the care of the seriously ill or injured patient.
As you prepare for Foundation Training, make sure you apply for a rotation that includes four months spent in an Emergency Department in your F2 year, and use your taster week in F1 if you can. Let you supervisor know early on that you are considering Emergency Medicine as a career and they can help to make sure you make the most of your time.
Emergency Departments provide plenty of opportunity for short audit or quality improvement projects for those who are enthusiastic, another great way to get involved and begin to build your portfolio.
Your local Emergency Department could be a good place to start – let them know you are interested and see if there are any other opportunities to be involved.
Training in Emergency Medicine puts you at the frontline of medical care and enables you to develop the knowledge and skills you need to manage the breadth of acute presentations.
During your training you will gain valuable experience working with a number of multidisciplinary teams in Emergency Medicine and other acute specialties. You will develop a wide range of clinical skills and competencies that you can put into action when needed. You will work alongside senior clinicians who will train you “on the job” and you will attend local teaching and regional training days.
As you progress further through training you will be supported to develop leadership and managerial skills, such as coordinating patient care across the department and supervising more junior colleagues. You will be encouraged to develop sub-specialty interests such as Paediatric Emergency Medicine, and given the opportunity to take time out of program to gain additional experience that will complement your training. This could involve anything from academic research, developing your skills as a clinical educator, or practising Humanitarian Medicine abroad.
Finally you will need to pass the fellowship exam (FRCEM) before the end of specialty training, when you will be awarded a CCT (Certificate of Completion of Training), which means you will be eligible to apply for a Consultant post in the UK.
Many doctors’ first experience of working in Emergency Medicine is a four month post during foundation training. This provides a good opportunity to get a feel for working in an Emergency Department, and start learning how to assess patients and make decisions with close supervision.
From here, the standard training pathway involves the Acute Care Common Stem (ACCS) (ST1-ST3), followed by Higher Specialist Training (ST4-ST6), taking a minimum of 6 years. This can easily be extended by out of programme time, sub-specialty training, or if you wish to work part time. Applicants can opt for “run-through training” which avoids the need for re-application after the first three years, subject to satisfactory progress.
An alternative route into training is provided by the DRE-EM (Defined Route of Entry into Emergency Medicine) programme. This is designed for doctors who have already gained additional experience in Emergency Medicine or other specialties, with entry at ST3 level.
These training pathways are described in more detail below. Of course, a career in Emergency Medicine is flexible, and many doctors follow a career path that includes time spent out of training or one that follows a different route altogether. For an overview of career paths and the links between them, see the EM Career Pathways Map.
Most trainees will start with the ACCS core training programme. During the first two years, trainees rotate through six month posts in Emergency Medicine, Acute Medicine, Intensive Care Medicine, and Anaesthetics. This broad experience in acute specialties equips you with the confidence and skills to manage the full spectrum of acutely ill and injured patients.
The third year is focused on gaining further experience in Emergency Medicine, and spending six months training in Paediatric Emergency Medicine, in preparation for Higher Specialist Training.
As you progress through training you will build an e-portfolio of your learning and achievements, supported by your educational and clinical supervisors. Your e-portfolio enables you to demonstrate increasing levels of competency and will be reviewed regularly to ensure you are on track with your training.
Prior to entering higher training at ST4 level you also have to successfully complete the FRCEM Intermediate exams, which are based on the competencies you have been working towards during the ACCS programme.
The DRE-EM programme provides an alternative pathway into specialty training for those with prior experience of EM and other acute specialties, or those who have completed basic surgical training. It also provides a method of switching from other ACCS programmes.
DRE-EM takes into account this prior experience and provides an opportunity to enter training at ST3 level. The programme is tailored to individual training needs, with a variable amount of time spent at ST3, enabling the trainee to gain any missing competencies or experience prior to entering Higher Specialist Training at ST4.
More information about DRE-EM and eligibility criteria can be found in the Exams & Training section of the College website.
As a senior trainee, you will spend your time working in the Emergency Department, consolidating and finely tuning your clinical skills. You will put them to good use, delivering care to the most seriously unwell or injured patients as resuscitation or trauma team leader. You will feel confident to approach any clinical scenario.
You will learn how to safely supervise more junior members of the team, and work with the consultant to coordinate care on the shop-floor and provide senior review. At other times you will be the most senior doctor in the department with on-call consultant support.
You will learn more about leading and managing the emergency care system, with dedicated leadership training and a management portfolio that you will build up through supported experience.
You will work towards completing your final FRCEM exams, which bring together all of the knowledge, skills, competencies and expertise you have learnt during training, and are used to putting into action in your daily practice.
The broad base of Emergency Medicine means that there is huge scope to develop a specialist interest in almost anything you can think of. Well recognised sub specialties and niche personal interests happily co-exist.
There are two recognised sub-specialties, Paediatric EM and Pre-Hospital EM, and trainees can also dual-accredit in Intensive Care Medicine. These sub-specialty options lead to recognised accreditation with the GMC. Trainees competitively apply for these posts during Higher Specialist Training.