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Acute Care Common Stem Training in Wales. Rachel Walpole Training Programme Director ACCS Wales. ACCS Training in Wales. What is ACCS? Who are ACCS Trainees? Why do we bother? What do they need from us? Where can I get help?. What is ACCS?. Multispecialty Core Training
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Acute Care Common Stem Training in Wales Rachel Walpole Training Programme Director ACCS Wales
ACCS Training in Wales • What is ACCS? • Who are ACCS Trainees? • Why do we bother? • What do they need from us? • Where can I get help?
What is ACCS? • Multispecialty Core Training • Only route to ST Emergency Medicine • Alternative route to ST Anaesthesia • 8 ACCS Anaesthetists • 30 Core Anaesthetists • Small minority of Physicians • Also route to ST ITU (+ any Primary Exam)
ACCS Training Programme Years 1&2: • 6 months “Acute” Medicine • 6 months Emergency Medicine • 6 months Anaesthesia • 6 months ITU Year 3: • 12 months parent specialty
CT3s in Anaesthesia • 6 months EM / Medicine • 6 months Anaesthesia (experienced) • NOT ACCS! • But ARCP requirements same • Happy to help
Pros and Cons for WSA • High novice load • Only 50% selected by us • 6 months of ITU continuity • And often ITU-enthused • Insight for other specialties • Net anaesthetic & ITU trainee gains
Where are ACCS trainees? • Cardiff • Royal Gwent • Swansea • North Wales: Bangor & Wrexham CT1 & CT2 on same site, usually also CT3.
Who are ACCS trainees? 12 ACCS trainees per site: • 4 CT1 • 4 CT2 (but still anaesthetic novices) • 4 CT3 16 each year: • 8 Anaesthetists • 6 Emergency Physicians • 2 Acute Physicians
Anaesthesia for ACCS 2010 • 6 month module • BASIS of anaesthetic practice • Initial Assessment of Competence • **MSF** • Educational Supervisors Report
ACCS Curriculum • 4 x 6 months • But a 2 year curriculum • 6 Major Presentations • 38 Acute Presentations • 44 Practical Procedures • Most during AM / EM
ACCS Workbook • Issued to all CT1s • Curriculum by specialty • All paperwork by specialty • Tickboxes to track: • Major Presentations • Acute Presentations • Practical Procrdures
Portfolio • E-Portfolio for Parent Specialty • Anaesthesia / ITU for “other” trainees: • Available on e-portfolio • But fraught with danger (Ed Sup access) • Paper is easier (but not obligatory) • Paper copy of all STRs for ARCP • Beware: MSFs are specialty-specific
Educational Supervision • Department ACCS Supervisor • “Specialist” Ed Sup • Same role as for anaesthetic Core Trainees • But familiar with ACCS quirks
Educational Supervision • Cardiff: • Melvyn Jenkins-Welch / Sabine Grundler • Swansea: • Tracey Wall / Vijay Kumar • Newport: • Helen Jewitt / Babu Muthuswamy
Educational Supervision • Bangor: • Alison Ingham / Alison Ingham • Wrexham: • Venkat Madhavan / Mahmoud Wagih
Parental Supervision • Parent Specialty Supervisor • Follows trainee for 2-3 years • Allows continuity of supervision • Source of careers / exam advice • Input depends on need • Essential input if difficulties
ACCS-Anaesthesia • CT1: • Emergency Medicine • Medicine • CT2: • Anaesthesia • ITU • Year 3: CT2 Anaesthesia
Recruitment • Central with CT Anaesthesia • 1 interview covers both • ACCS & CT programmes ranked by trainee • Allocation by interview score • Other specialties separate
ACCS Challenges 1 • The Problem Trainee: Communication!!!! • Difficult to progress more slowly • Gaps • Maternity & Sick Leave • Part-Timers • Paperwork / e-portfolio Confusion
ACCS Challenges 2 • Multi-specialty STC • Variable engagement • 2 year Curriculum • WPBAs at any time…… or never • Discrimination • Career Changes • Re-selection Mandatory • But generally achievable without difficulty
ACCS Challenges 3 Parent Specialty Teaching Requires S/L if on another module Exams Difficult to achieve Frequent changeovers And changes of heart No career specialty till CT2 Encourage early planning……
ACCS Challenges 4 EM need more throughput for ST posts Only route in is ACCS More novice anaesthetists ?where More Anaesthetic CTs also needed
ACCS Leads Leads for ACCS each site: • Cardiff – Melvyn (Anaesthesia) • Swansea – Dindi Gill (EM) • Bangor – Alison Ingham (An’a & ITU) • Wrexham - Ben Thomas (Medicine) • RGH - Rachel Walpole (Anaesthesia)
Specialty Leads • ACCS Lead for Anaesthesia • Rachel.Walpole@wales.nhs.uk • ACCS Lead for ITU • Alison.Ingham@wales.nhs.uk • Lisa - of course!!
Summary • ACCS numbers not high • But all novices; beware the CT2s! • 6 months in Anaesthesia • Curriculum as CT Anaesthesia Novices • And need MSF (remember Feb movers) • 50% are career anaesthetists • Communicate any problems… please!