The Curriculum is designed to lay out what is required to be a specialist in Emergency Medicine in the UK. The curriculum Purpose Statement outlines why Emergency Medicine is vital to the patients of the UK and a key element of the National Health Service.
The curriculum itself describes how EM trainees will be trained. It is the result of a significant exercise whereby experienced EM trainers and training and assessment experts have sought to describe an effective approach that can be delivered. The following is a description of how learners and trainers can get the best out of it.
Generic Professional Capabilities
The General Medical Council requires all curricula to include Generic Professional Capabilities. These are designed to foster a common set of skills, attitudes and behaviours in the trainee workforce that might transferrable if needed. They are included verbatim here in the RCEM curriculum to ensure trainees and trainers are aware of what is required.
Specialty Learning Outcomes
All UK curricula are formulated around what a specialist needs to be able to do independently to serve the health needs of the UK population. The requirements of an EM specialist in this setting are articulated in the Specialty Learning Outcomes.
The Generic Professional Capabilities that relate to each of the Speciality Learning Outcomes are listed for reference. Each of the Speciality Learning Outcomes have EM specific Key Capabilities described. These are the specific, contextualised aspects of the Specialty Learning Outcome that are fundamental to the practise of EM in the UK.
The Knowledge, Skills, Behaviours and Attitudes section gives examples and further guidance for trainees and assessors about what is required. The Specialty Learning Outcomes are designed to support the development of trainees in all dimensions needed to deliver expert EM care effectively. By covering the human factors at play we aim to make the implicit explicit.
The expertise of an EM specialist working within the NHS involves knowledge and technical skills. The breadth of the clinical presentations or pathophysiological processes that need to be known by EM specialists are listed as the Syllabus. Up to date knowledge and understanding of the assessment of treatment of patients presenting in these ways will be a key part of training. The knowledge and understanding will be the subject of private study, departmental and regional teaching and will be assessed in the RCEM Programme of Assessment, in particular the formal examination schedule.
The clinical knowledge and understanding outlined in the Syllabus is applied in a setting of varying demands, interspersed with rare and challenging situations, delivered by a workforce with a range of experience and the need for overview and leadership from the EM specialist. The Specialty learning Outcomes are organised to ensure all aspects are made manifest.
The purpose of training for the Specialty Learning Outcomes is the application of clinical knowledge to patient care in the ED RCEM’s vision for the provision of training in the workplace is that it acknowledges the challenge that leadership in the ED represents. It also acknowledges that all have strengths and weaknesses that can be both refined and offset.
Programme of Assessment
The best use of training in the workplace for learners is to find areas of challenge and to seek and reflect on feedback from trainers. In the curriculum these are grouped within the 12 Speciality Learning Outcomes we have described. It is important to develop in all 12. The requirements at each stage of training are laid out in the Programme of Assessment.
The idea underpinning assessment is not that a tick list is followed or a specific number of assessments accumulated. It is rather that there is a shared understanding of where trainees need to get to, in terms of the degree of independence, at the next stage of training and that training is geared to readying them. Trainers know which situations and circumstances are demanding and can guide learners to experience these, with support, in the workplace. That is the point of workplace encounters that are recorded in the RCEM e-portfolio. To that end, assessment in the workplace should start at the beginning of the training year and pitched at outer edges of the trainees’ ‘comfort zone’.
Expertise in EM is pivotal to the good health of communities in the UK. It is hard won, complex and requires a spread of knowledge, skills and attributes that are often called on all at once. This curriculum sets out what these are and is designed to support their development, integration and assessment. Our aim is that it is used as the map to guide the pursuit of excellence for individuals and allow them to grow to be clinicians who can thrive career long in the ED.