That an Australasian College of Emergency Medicine (ACEM) training program based from Wellington and incorporating; Palmerston North (PNH), HawkeÕs Bay Regional (HBR) and Hutt Valley Hospital (HVH) Emergency Departments will be established. This will be known as the Central Regional Training Program.
The goals of this training program will be to
The training program for the ACEM involves four distinct sections
a. 6 or 12 months of approved ED
b. 6 months in approved NON-ED position
c. Part I Examination
a. 30 months ED
i. 12 months in a approved Adult ED.
ii. Trainees from 01/01/2003 are required to work 6 months in a Major Referral Hospital and 6 months in urban district or major regional hospital
b. 6 months Minimum paediatric requirement / Paediatric Log Book (PLB)
i. 6 months Approved Paediatrics ED orÉ
ii. 12 months Approved mixed department orÉ
iii. Combinations of Non-ED paediatrics and ED.
c. 18 months Non ED
i. Max of 12 months in
1. Anaesthesia, ICU, Gen Med, Surgery
ii. Max of 6 months in
1. Psychiatry
2. Special Skills
Must be completed before Part II can be attempted.
Wellington currently approved for 12 months ED only, therefore ALL trainees are currently required to rotate to other institutions for further training during their 48mths of advanced training. Currently trainees must organise themselves to leave the region and possibly the country. While our general philosophy is that outside experience is of great value, it is also recognised that it places limitations on trainees with families and makes the Wellington region less attractive for long term planning. By gaining accredited Hospitals in the region the CRTP also fulfils the requirement that trainees from 01/01/2003 are required 6m in Major Referral Hospital and 6m in urban district or major regional hospital. It will also enable many trainees to remain Òclose to homeÓ for the majority of their training.
It is increasingly difficult for trainees to find ÒserviceÓ positions available that have a suitable level of training to be recognised by ACEM. By maintaining a central registry of trainees the Regional Training program will be able to approach other Departments to provide staff on a regular rotation. These rotations will be sought in; ICU, Anaesthetics, Paediatrics, General Medicine and Surgery. Additional special skills rotations will be sought on request.
The Department of Emergency Medicine, Wellington Regional Hospital, is responsible for overseeing the creation, initiation and maintenance of the program for at least two years. This will involve regular meetings with those FACEMÕs from the respective departments as DEMTÕs or who will be nominally responsible for trainees in their area. After the first two years the position of CRTP chair can rotate to one of the other areas.
Whoever holds the chair for the CRTP will maintain the registry of all trainees in the region and have responsibility organising the meetings for distributing trainees to the various regional departments.
Wellington is currently responsible for creating a teaching program for Part I and II exams. While teaching themes and timetabling will be initiated by Wellington, actual content and provision of the program will rely on input from all FACEMÕs in the region. Experienced MOSS Emergency Physicians who are keen on teaching are also invited to be involved.
Wellington will also provide support and advocacy to the regional departments for matters of accreditation and credentialing.
All FACEMÕs in the region are responsible for the day-to-day supervision of trainees in their departments. Regional departments can register their own local DEMT with the college if they wish, but this will not be mandatory in order to have trainees as oversight within the program can be provided by the Wellington DEMT. However, each ED will a FACEM willing act as liaison with non-ED training programs. FACEMÕs and interested MOSS officers will be expected to participate in the overall teaching program and may at times be asked to set-up teaching weekends in the regional centres for all trainees to attend.
The teaching program has a number of elements. Each Hospital will be expected to have its own in-house education as necessary to maintain standards and the teaching requirements of their own institution and corporate body. Wellington will have itsÕ teaching program on a Wednesday afternoon. The program will run as follows.
All trainees who are able to attend may do so on a Wednesday from 1400 hrs. Provision will be made available throughout the year for video-conferencing of key tutorials or special topics.
A 9 month structured basic science course. The tutorials are intending as a guide to study and exam format. Candidates will be encouraged to formulate multi-choice questions and will get exposed to viva presentations. The scheduling of this will depend on numbers. Smaller numbers may be best accommodated outside normal working hours. Larger groups currently have teaching on Thursday afternoons. Regional candidates will receive local teaching and topics by email / internet.
Special teaching sessions will be held over weekends to provide focused tutorial sessions. 60% of these will be held in Wellington the remainder will be hosted in a Regional Centres. These special sessions will be concentrated towards exam time.
Part II training forms part of the ongoing education of all advanced trainees. It occurs everyday through the supervision of registrars as they work. Departmental teaching over 12 months should cover both general training and in-house Q&A needs. The focus needs to be on both topics of Emergency Medicine care and on key competencies of an Emergency Specialist, namely.
The specific Part II program focuses on those candidates eligible in their final advanced year for the Part II exam.
A concentrated study program over 6 months focuses on knowledge and exam technique. The Part II program will run independently from general teaching and currently will be held on Thursday afternoons. The sessions will consist of two hours of interactive teaching.
Candidates will be expected to complete VAQ and SAQ questions returning them to the DEMT / Supervisor for marking and reviewing. They will be posted/emailed to regional candidates. The program will be timed to peak prior to the written exams. Those candidates successful with the written exam will then receive teaching for the clinical examination
[1] Training and Examination Handbook 01/2004 ACEM