Transcript ACCS Training in Wales

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:


Swansea:


Melvyn Jenkins-Welch / Sabine Grundler
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:



CT2:



Emergency Medicine
Medicine
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


ACCS Lead for ITU


[email protected]
[email protected]
Lisa - of course!!
Summary

ACCS numbers not high



6 months in Anaesthesia
Curriculum as CT Anaesthesia Novices



But all novices; beware the CT2s!
And need MSF (remember Feb movers)
50% are career anaesthetists
Communicate any problems… please!