Acute Care Common Stem (ACCS)


The Acute Care Common Stem training pathway is a successful product of Modernising Medical Careers. ACCS gives doctors broad-based training in the acute care specialties before embarking on training in their parent specialty of anaesthetics/intensive care medicine, acute medicine or emergency medicine.


It is open to any doctor with Foundation 1 and 2 competencies and provides excellent training in acute care specialties. A good background in medicine is particularly useful in anaesthesia and trainees who have completed ACCS will appear competitive at the time of ST 3 recruitment.


The ACCS Programme

ACCS training in Anaesthesia is a three year programme. In the first two years trainees will complete one year of anaesthetics and ICM, (usually six months of each but possibly nine months anaesthesia and three months ICM) and six months of acute medicine with six months of emergency medicine. The order in which these modules are done is variable. If competencies are successfully achieved, the trainee then moves into CT 2 anaesthesia for the final  year.


As a result of the year spent training in emergency medicine and acute medicine this means the training programme is extended by a year from seven years to eight. The training scheme is  uncoupled, meaning that the post is for three years after which trainees would have to re-apply for a ST 3 post in anaesthetics.


For further details regarding the ACCS programme please visit the ACCS website


ACCS Competencies

Each module has specific competencies that should be achieved. Whilst this may appear daunting, there is considerable overlap between the curricula for each module and consequently many of the competencies can be achieved across many of the specialities.  The ACCS Curriculum can be found here.


ACCS Supervision

Trainees will be appointed an educational supervisor from your parent specialty who will oversee your progress and needs during the ACCS programme. Whilst you are in Acute and Emergency Medicine you will also be appointed an educational supervisor from these host specialties to provide advice and support for your education in those modules. You should remain in contact with your parent specialty educational supervisor whilst you are ‘out’ for the year.


The Training Programme Director for ACCS is Dr Naomi Hancox.

Pre-Hospital Emergency Medicine (PHEM) Training Program


Pre-hospital emergency medicine (PHEM) is a new sub-specialty area of medical practice focusing on the specialist provision of on-scene emergency care combined with in-transit critical care. Although BLSA supports PHEM training, recruitment is national linked and applications must be made independently of the school through the HEE website.


Training in PHEM is only through approved training programmes in Anaesthetics, ICU, Emergency Medicine and Acute medicine. It is undertaken after ST5 (or post CCT) and once successfully completed will confer sub-specialty accreditation against your GMC CCT.


At present, PHEM posts for Anaesthesia trainees are mostly 1 year full time appointments. However, some job plans for Emergency Medicine trainees are split; 3 weeks air ambulance and 3 weeks within the emergency department over a 2 year time frame.


Preparation for PHEM Training


Requirements for Anaesthetists

  • FRCA primary at time of application

  • National training number

  • Minimum of 6 months training in an approved training post in Emergency Medicine at CT1 or equivalent


Essential Courses

  • Trauma and Life support courses (instructor status desirable)

  • ALS

  • ATLS



Additional courses


  • PHEC run by Basics



Conferences in Pre-Hospital Care

  • London Trauma Conference

  • Social Media and Critical Care (SMACC)

  • Trauma Care

  • Basics




RCOSed DIP IMC (only undertaken once working extensively in pre-hospital care) this is the halfway point for PHEM trainees, followed up in the remaining 6 months post by the fellowship.


Ways to get more involved in Pre-Hospital Care

  • Observed shifts with London ambulance service

  • Observer posts with Air ambulances Teams. The following teams are the closest to East London (London air ambulance, KSS, EAAA, Magpas)

  • Clinical Governance days

  • Events work – marathon volunteer, private companies, music festivals

  • Networking at work (speak to people who have worked in this field), chat to people at courses and via social media (FOAMed, Twitter, Facebook)



Applicants need to be physically fit. As a result a fitness test must be completed prior to application and appointment, click here for more details.



Further information

For further information please visit The Intercollegiate Board for Training in Pre-Hospital Emergency Medicine website. You may also find the links below helpful.

RCOA - PHEM Training Programme

British Association of Immediate Care Schemes (BASICS)

Social Media and Critical Care


 The London Trauma Conference 

For further information,  please contact Dr Tom Hurst at King's College Hospital