The ST3 trainee will be expected to complete 6/12 in the ED with a muscular skeletal focus (MSK) or other Musculoskeletal training opportunity, and 6/12 in the ED with a Paediatric EM focus (PEM) or acute paediatric medicine post. The criterion for this training is outlined in “Guidelines for Postgraduate dean/Transitional board for Scotland on developing run through training programmes in EM”
The assessment process for ST3 follows a common theme to that of the ACCS years. The trainee must meet with their Educational Supervisor (ES) 3 times in each 6/12 training period. It would be desirable to have a separate ES for MSK and PEM, but not essential (as there may be insufficient senior staff to comply with this). However there must be one person with overall view of the progress during ST3, who should be an EM Consultant and who can complete the STRs prior to the annual review.
Educational objectives should be set at the start of the post and these should identify any additional out of department training that will be required. At least 6 WPBA’s for each six months need to be completed and clinical cases can be chosen from the lists below. Assessments at ST3 must be completed by ST6 trainees, associate specialists or consultants (except for Mini PATs and MSF). Trainees need to retain a hard copy and send a copy to their ST3 ES for completion of the STR
ESs and trainees will be expected to produce two STRs, one each from MSK and PEM. These STR will form the basis of the annual review.
Some deaneries have arranged ST3 programmes that contain experience based on the paediatric or orthopaedic wards as part of the ST3 year. It is vital that all ST3 trainees have a nominated specialty Consultant during this time, who should meet with the trainee at least once. It may be appropriate for this speciality trainer to provide a STR (depending on how much time is spent in the specialty) or for them to inform the overall ES or CT if there is any cause for concern.
During the 6/12 of MSK training the trainee will be based in the ED and have a focus of training in musculoskeletal injuries and trauma. This will most commonly be delivered during shifts in the ED, using a combination of working in specific areas such as minor injuries and the Resuscitation room. There may also be a day release education programme whereby the trainee can attend speciality clinics outside of the ED, such as fracture clinics or radiology sessions. This should be approved by the local TPD and ES and agreed at the start of the post.
Some deaneries may have also arranged programmes whereby the ST3 trainee may spend time on the trauma and orthopaedics wards. It is vital that during this time the trainee has a named specialty supervising Consultant.
It is not expected that the trainee would have gained all of the competencies in MSK injury by the end of the ST3 year. However any outstanding training needs should be clearly identified in the MSK STR so that they can be addressed in the ST4-6 years. Consequently it is important to have an STR for both MSK and PEM.
The choice of clinical cases for WPBA’s is based on common MSK conditions and development of leadership skills in the management of major trauma. Six WPBA must be completed and these need to be assessed by a ST4 doctor or above. Trainees need to retain a hard copy and send a copy to their ST3 ES for completion of the STR
Paediatric Emergency Medicine PEM
PEM will require the trainee to be based in an ED that has an EM Consultant with a Paeds EM interest. The latter should ideally be the ES for these 6 months. The trainee will spend the majority of the day shifts working in the children’s area and during this time will need to complete at least 6 WPBAs from the list of clinical cases provided below. These assessments must be completed by a ST4-6 doctor or above. A hard copy is retained by the trainee and another sent to the ES for the ST3 year.
Some deaneries may have also arranged programmes whereby the ST3 trainee may spend time on the acute paediatric wards (or on PICU). It is vital that during this time the trainee has a named specialty supervising Consultant.
It is unlikely that the ST3 trainee will gain all the competencies required for PEM during 6 months. Any outstanding competencies need to be identified in the PEM STR, so that they can be addressed during ST4-6. Consequently it is important to have STR’s for both MSK and PEM.
The choice of clinical cases for WPBAs in PEM is based on the common presentation of acute conditions and development of leadership skills.
