Training Programme for Emergency Medicine 
The most recent (5th Edition) of the Guide to Emergency Medicine Training in Ireland was published in October 2011.
Training Body
Training in Emergency Medicine is directed by the Irish Committee on Emergency Medicine Training (ICEMT) which is currently based in RCSI. The Committee was known as the Advisory Committee on Emergency Medicine training (ACEMT) up to May 2011. Terms of Reference of the Committee effective from July 2010 are available here.
Structure of Training
Basic Specialist Training in Emergency Medicine (BSTEM)
Basic Specialist training in Emergency Medicine consists of a series of relevant posts at Non Consultant Hospital Doctor (NCHD) level that lay the professional groundwork for subsequent specialisation. During this time, doctors obtain a wide range of experience in a variety of specialties, of which a minimum of 12 months must be spent in Emergency Medicine (EM). A further 12 months must be in specialties relevant to EM e.g. acute general medicine/geriatrics, paediatric emergency medicine or general paediatrics, general surgery, trauma/orthopaedic surgery, anaesthesia and critical care medicine.
Whereas previously, most basic trainees will have gained the relevant experience through a combination of stand alone posts, a minority will have been part of "employer driven" basic EM schemes e.g. St. James's Hospital, St. Vincent's University Hospital schemes. Since July 2011, a national Basic Specialist Training Scheme in Emergency Medicine (BSTEM) is in place which has incorporated those posts currently part of "employer driven" schemes. The scheme is of 3 years duration and incorporates training in EM, Paediatric EM, acute medicine, anaesthesia & critical care and musculoskeletal EM/trauma & orthopaedic surgery/plastic surgery. There will be up to 26 posts available annually with a total of 78 trainees on the national programme at any one time.
BSTEM will culminate in eligibility to sit the relevant postgraduate examination, Membership of the College of Emergency Medicine (MCEM). Success in this examination, when combined with BSTEM, confers eligibility to apply for HST.
Entry Qualifications to apply for Higher Specialist Training in Emergency Medicine (HSTEM)
All doctors entering HST in Emergency Medicine must hold MCEM.
MCEM Examination
MCEM is administered by the College of Emergency Medicineand consists of three parts:
- Part A - MCQ exam in basic sciences as applied to EM. Part A may be taken in the first SHO year.
- Part B - Data interpretation
- Part C - Objective Structured Clinical Examinations (OSCEs)
Eligibility criteria for Parts B & C, as presented in the MCEM regulations, relate largely to the UK training system. For Irish trainees, parts B & C may be taken no sooner than 26 months after commencing BSTEM. This period includes a minimum of 12 months of EM and 12 months in specialties relevant to EM (comprising 2 six month periods in any two of acute medicine, anaesthesia / intensive care medicine, acute paediatrics / paediatric EM or orthopaedics and trauma). On that basis, trainees will usually be in their third SHO or first registrar year before completing MCEM. Part B is normally taken about six weeks before Part C. Success in the former is required before progression to the latter.
Higher Specialist Training in Emergency Medicine (HSTEM)
Currently, there are over thirty Higher Specialist Training posts in Emergency Medicine in Ireland. Each trainee rotates through several hospitals to maximise their training opportunities. Hospitals are visited by an external training body to ensure training standards are up to internationally agreed standards.
The Emergency Departments currently recognised for HST in Emergency Medicine are
- Beaumont Hospital
- Connolly Hospital, Blanchardstown
- Cork University Hospital
- Mater Misericordiae University Hospital
- Midland Regional Hospital, Tullamore
- University (formerly Mid Western Regional) Hospital, Limerick
- Our Lady's Children's Hospital, Crumlin
- Our Lady of Lourdes Hospital, Drogheda
- Sligo Regional Hospital
- St. James's Hospital
- St. Vincent's University Hospital
- University Hospital, Galway
- Tallaght Hospital, Dublin
- Waterford Regional Hospital.
Duration of HSTEM
HSTEM is designed individually according to the previous experience of each trainee, but must fit into a uniform broad framework to ensure that training is completed satisfactorily in every case. The duration of HSTEM is five years. A minimum of 4 years must be spent in the practice of Emergency Medicine on the HST programme. Some retrospection may be granted for pre-HST experience at Registrar level in Emergency Medicine and in Anaesthesia/Intensive Care Medicine and Paediatric Emergency Medicine. An additional period may be used to obtain recognised training in a sub-speciality, such as Paediatric Emergency Medicine. Time in posts nominally at Registrar level in Emergency Medicine, but prior to obtaining a higher diploma, cannot be counted towards HST. Completion of training requires a satisfactory Record of In-training Assessment from the Irish Committee on Emergency Medical Training (ICEMT) and success in the Fellowship of the College of Emergency Medicine (FCEM) examination.
FCEM Examination
Trainees are required to pass the Fellowship Examination of the College of Emergency Medicine (FCEM) in order to be eligible for a Certificate of Specialist Doctor. The examination may be taken once the trainee has had a satisfactory assessment of completion of the fourth year of training. The FCEM is administered by the College of Emergency Medicine at Churchill House, 35 Red Lion Square, London, WC1R 4SG. CEM has an updated curriculum for FCEM, and this curriculum is the basis for a rolling two-year programme of SpR study days, which take place nationally on the last Friday of every month and at which attendance is compulsory.
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