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Acute Specialities

Once they have completed the Foundation Programme, doctors wishing to progress to specialist training in the acute specialities will follow the Acute Care Common Stem (ACCS). This consists of a three years of core training programme (CT1 – CT3), followed by higher speciality training in their parent speciality thereafter (ST3 – ST8).

The Acute Specialities

The acute specialities comprise:

ACCS provides the only entry point for higher training in Emergency Medicine, and an alternative entry point to training in Acute Internal Medicine, Anaesthesia, Intensive Care Medicine and over 30 JRCPTB specialities.

The ACCS training consists of:

Acute Internal Medicine

The third year of ACCS training is spent in Acute Internal Medicine, ensuring trainees achieve all required competencies required for progression to higher training in Acute Internal Medicine or over 30 approved JRCPTB specialities.


Undertaking ACCS as opposed to CAT provides anaesthetic trainees with a broader acute background, ideal for those with an interest in emergency anaesthesia and trauma. The third year of ACCS training is spent in anaesthesia, whereby, after successful completion of the Primary FRCA and associated competencies, trainees can apply for higher specialist training (ST3).

Emergency Medicine

The third year of ACCS training is split between adult and paediatric emergency medicine. Typically six months are spent undertaking further adult emergency medicine training focusing on musculoskeletal and trauma, followed by six months in paediatric emergency medicine. Successful completion allows trainees to apply for higher specialist training (ST3).

Intensive Care Medicine

Intensive Care Medicine can be obtained as a single or dual CCT, combined with Acute Internal Medicine, Anaesthesia, or Emergency Medicine. For single CCT trainees, the third year of ACCS will be spent in Intensive Care Medicine, whilst this may be delayed until later during training for dual accreditation trainees.

On-Call Rota for a Acute Specialties

Acute trainees will take part in the on-call rota throughout most of their placements, although typically will not form part of the on-call rota for the first three months of anaesthetic training until the Initial Assessment of Competence (IAC) has been completed allowing trainees to work without direct supervision.


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