It has been announced that a new defined routes of entry into emergency medicine specialty training will be introduced in 2014. This is one of the actions arising from the HEE Emergency Medicine Workforce Implementation Group and will be delivered by Health Education Yorkshire and the Humber (HEYH) in conjunction with the College of Emergency Medicine. The DRE-EM initiative will appoint candidates with transferable competencies as outlined in the person specification to specialty training through a national selection process (hosted by HEYH) to ST3 Emergency Medicine. Please see the attached ‘Quick Guide’ for further detailed information about DRE-EM and the link to Health Education Yorkshire and the Humber
The purpose of DRE-EM is to allow a route of entry for those who have transferable competencies from surgical training at core level, and experience from ACCS related specialties. The intention is to increase throughput whilst maintaining quality. The initiative is innovative in many ways and aligns with principles set out in the Shape of Training report.
The person specification (attached) outlines two routes within DRE-EM ST3 Emergency Medicine. It is recognised that successful applicants are likely to need between 12-24 months at ST3 level prior to progressing (run through) to ST4. Candidates will usually require one year of Emergency Medicine training, plus potentially additional time in other ACCS related specialties (Anaesthesia, ICM and/or Acute Medicine) to fulfil the requirements to enter ST4. An assessment will need to be made by the local training programme working with the College of Emergency Medicine of each applicant’s transferable competences and a bespoke training programme will need to be created to support the early years of successful DRE-EM applicants. It is recognised that there are potential training capacity and cost implications for those requiring additional training time in ACCS related specialties.
The General Medical Council has recently approved DRE-EM leading to Certificate of Completion of Training (CCT) for trainees appointed from a surgical UK approved training programme, as per the person specification attached.
What is DRE-EM?
Defined Route of Entry into Emergency Medicine, ‘DRE-EM’, is an entry point into Emergency Medicine specialty training. DRE-EM is new in 2014, and has its own national selection process – with applications opening on 3 February 2014. The intention of DRE-EM is to increase recruitment to Emergency Medicine training whilst maintaining quality.
Person Spec DRE-EM 2014
Who is eligible to apply to DRE-EM?
The person specification for DRE-EM clarifies two routes. One route is to enter into Emergency Medicine specialty training, having successfully completed two years of a UK core surgical training programme or two years of a run through surgical training programme in the UK, with evidence of achievement of CT/ST1 competences in surgery at the time of application and CT/ST2 competences in surgery by the date the post commences. Entry via this route leads to a Certificate of Completion of Training (CCT) in Emergency Medicine.
The other route is to enter into Emergency Medicine specialty training with evidence of a minimum of 24 months at core trainee level (not including time spent within a Foundation programme or equivalent) in any ACCS specialties (Anaesthesia, Emergency Medicine, Intensive Care Medicine or Acute Medicine), of which at least 12 months must be in Emergency Medicine, with at least 6 months of this worked within an Emergency Medicine environment similar to that seen in the UK and at least 12 months worked in the UK as a fully registered medical practitioner OR completion of the equivalent of core surgical training with evidence of achievement of CT/ST1 competences in surgery at the time of application and CT/ST2 competences in surgery by the time of appointment. This route leads to a Certificate of Eligibility for Specialist Registration – Combined Programme (CESR CP) in Emergency Medicine.
Please note that any time periods specified in the person specification refer to full time equivalent, and there are additional requirements detailed in the person specification. It is important that applicants ascertain that they are eligible. Applicants must meet all essential criteria for the programme to which they are applying. The person specification clearly states which elements are required for both routes, the CCT route and the CESR CP route.
Where can I find the person specification?
Please visit Health Education England’s Specialty Training website or visit the Health Education Yorkshire and the Humber recruitment DRE-EM website to download the person specification.
What is a CESR CP?
The Certificate of Eligibility for Specialist Registration - Combined Programme (CESR CP) route allows applicants to be appointed above ST1/CT1 level to a LETB/Deanery and General Medical Council (GMC) approved training programme. They are awarded a National Training Number (NTN), but at point of entry to the programme have previous training that has not been prospectively approved by the GMC to count. Trainees in these circumstances will have an NTN ending with the suffix ‘L’.
The certificate does not replace the Certificate of Completion of Training (CCT) and is not the same thing as a CESR. Trainees who are awarded the CESR (CP) will be recommended to the GMC for Specialist Registration in the same manner as a trainee on the CCT route. Trainees will thus be able to work as substantive consultants in the UK.
Where can I find further information about CESR CP?
The GMC website provides further information. Please visit: http://www.gmc-uk.org/doctors/cpfaqs.asp#1 Please do not contact Deanery/LETB offices for information on CESR CP as the offices will not be in a position to offer advice on individual circumstances and eligibility.
At what level will successful DRE-EM applicants be appointed?
Successful DRE-EM applicants will be offered an appointment to an “ST3 Emergency Medicine” post. Prior to the successful applicant commencing in post, a review will be conducted by the College of Emergency Medicine, in conjunction with the local training programme, to define transferable competences and establish future requirements. A decision will be made as to the additional time/competences required prior to moving to ST4 Emergency Medicine. Successful applicants will usually undertake a minimum of one year of Emergency Medicine, plus additional time as needed in Acute Medicine, Anaesthesia, Intensive Care Medicine, etc. It is recognised that successful applicants will normally require between 12 months and 24 months at ST3 level prior to progressing to ST4 Emergency Medicine.
Does DRE-EM provide uncoupled or run through training?
DRE-EM provides run through training; successful applicants will progress through ST3, ST4, ST5 and ST6 automatically, subject to meeting all curriculum requirements and College exams.
If I am appointed to DRE-EM ST3 Emergency Medicine, do I need to take and pass the Membership of the College of Emergency Medicine (MCEM) examination prior to commencing ST4?
Yes, successful applicants are required to pass the MCEM examination, and all other ACCS/core EM competences, prior to moving to ST4 training.
Are applicants from a surgical training background – either from a UK approved programme or an equivalent programme - required to have achieved the Membership of the Royal College of Surgeons (MRCS) examination?
If candidates are applying via the CCT route, they are required to have achieved MRCS.
If candidates are applying via the CESR CP route (equivalent surgical training), they are not required to have achieved MRCS.
I do not meet the ST3 DRE-EM nor the ST4 EM person specifications, but I am interested in applying for Emergency Medicine training? At what level should I apply?
Those who do not meet the ST3 DRE-EM or ST4 EM person specifications should refer to the ACCS EM ST/CT1 person specification and consider whether they are eligible; there is no ‘upper limit’ in terms of time/experience within this person specification.
Is there an upper experience/time limit for DRE-EM applicants?
No. The intention is to allow entry from a broad range of applicants, but applicants will have to demonstrate that their career progression is consistent with personal circumstances and that their achievements and performance is commensurate with their total period of training or experience.
How will the national recruitment process work?
The national recruitment process will be hosted by Health Education Yorkshire and the Humber. There is one national application form for DRE-EM Emergency Medicine ST3. Therefore, eligible candidates will apply and be interviewed under one process, irrespective of whether they are applying for the CESR CP route or CCT route.
Longlisting will take place in line with the person specification after the closing date.
Short-listing will only be undertaken if required.
Applicants will be asked to preference all Units of Application within LETBs/Deaneries, although it is not yet certain whether all LETBs/Deaneries will have vacancies. If a candidate preferences a LETB/Deanery which does not have vacancies, the system will skip to the next preference on the candidate’s preference list, and so on.
Applicants do not have to preference all Units of Application (they can preference as many, or as few as they like) but are encouraged to consider their choices carefully.
Once the upgrading offer deadline has passed, should additional vacancies be realised by local LETBs/Deaneries, these will be offered to the next appointable candidates on the reserve list.
For all DRE-EM applicants, the interview format will be a multi-station selection process. Thorough checks will be carried out by Consultant faculty to confirm eligibility. Whilst the station questions will be the same for those applying under the two routes, there will inevitably be some differences in terms of supplementary questions, as a result of the differing backgrounds of the two routes. A comprehensive scoring matrix will be used to ensure that all applicants from both routes are equitably assessed and are on a ‘level playing field’.
DRE-EM applicants will be ranked on one list, and offers will be made based on this single list, with the top candidate being offered their preferred post (subject to available vacancies).
Why is the CESR CP process limited to trainees who have a background in ACCS specialties or equivalent surgical training?
Analysis of training curricula has confirmed that applicants from these backgrounds have transferable competences, which in turn allows the training period to be shortened.
Why are only applicants who have completed Core Surgery Training in a UK programme (or two years of a surgical run through UK programme) eligible for the CCT route?
In the first instance the GMC have only approved this route, which will be evaluated after a two year period. It is recognised that surgical trainees will have transferable competences and may wish to pursue a career in EM.
It is conceivable that the GMC may further explore widening the entry from other core specialties following the initial evaluation.
Where do I find out further information – such as how to apply, where the interviews are happening, timeline for when applications open/close, etc?
Please visit the Health Education Yorkshire & the Humber (lead LETB for Emergency Medicine) website; the recruitment pages provide further information about DRE-EM.
Am I allowed to have an inter-deanery transfer under DRE-EM?
Inter-deanery transfer (IDT) applicants must meet the eligibility requirements under the national IDT process, but in addition to this the “receiving” LETB/Deanery must confirm whether they can support the applicant’s training requirements.
How have the documentation and process been developed?
The person specification, documentation, FAQs and the process have been developed by the College of Emergency Medicine and Health Education Yorkshire and the Humber, having undergone legal scrutiny. Whilst legal challenge can never be ruled out, it is considered that the person specification and processes to be applied are reasonable.
I am a trainee considering a change in specialty, and think EM may be right for me. Who can I speak to?
Trainees may seek views from trainers, senior trainees, trainee representatives, other faculty and careers advisers. Heads of Schools and Training Programme Directors in Emergency Medicine can be identified on local LETB/Deanery websites.
Is this process subject to change?
Whilst this document outlines the planned direction for DRE-EM, like any new process we will be reviewing and monitoring plans, implementation of the process and management of this initiative. As such, all aspects of DRE-EM national selection are subject to change at any stage.