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Emergency medicine

Doctors working in emergency medicine (EM) (also known as Accident and Emergency medicine) respond to cases of major trauma, medical emergencies and large volumes of minor injuries and illness. In some respects, the EM specialist could be seen as the hospital equivalent of a primary care practitioner such as a GP.

EM specialists handle new cases as they arrive in hospital and their decisions can have immediate impact on the management of an illness or injury. This impact frequently stems from the specialist’s judgement of a patient’s condition and state, and the ensuing referrals to medical colleagues for continuation of intensive treatment. The working environment for an EM specialist is often hectic and unpredictable. It is fast-paced, challenging and heavily multidisciplinary.

Associated sub-specialties: Paediatric emergency medicine and pre-hospital emergency medicine.

  • Skills, rewards and challenges

    Skills

    • Good organisational and diplomacy skills
    • Adaptable
    • Strong leadership
    • Calm under pressure
    • Ability to multitask
    • Compassion
    • Lateral thinking
    • Time management skills

    Rewards

    • Diversity of people and emergency problems
    • Fast paced
    • Multidisciplinary
    • Flexible training and working

    Challenges

    • Requires some shift work
    • Stressful
    • Opportunities to follow-up patients long term are limited
  • Training

    The specialty training programme is competence-based, usually of six years duration. The programme is divided into three years core specialty training and three years higher specialty training. In England, Wales and Northern Ireland entry to higher specialty training is by competitive application.

    Core Specialty Training consists of two years of Acute Care Common Stem (ACCS) training followed by a further year gaining additional competencies in adult and paediatric EM. In Scotland the programme runs through from years one to six.

  • Inside look: accident and emergency consultant

    Specialising in forensic medicine, event medicine and crowd medicine for Queen's Park Rangers and Charlton Athletic Football Clubs, and Earls Court.

    What factors influenced your decision to choose this branch of medicine?

    I like variety.

     

    How many hours do you work in a typical week? How intensive is your work schedule?

    A&E: 20 hours - very intensive shift based work with very stressful four hour targets. Forensic/event medicine: 20 hours - again very intensive shift based work. The fear of medical negligence is much higher. Home matches for QPR and Charlton, and show concerts at Earls Court, as required.

     

    Is there scope for flexibility, for example part-time work?

    Very much so.

     

    What are the highlights and advantages of working in this specialty?

    Variety, experience of the other side (criminal justice) and seeing how the police work.

     

    What are the challenges and disadvantages?

    Driving in rush hour traffic.

     

    What are the routine aspects of your role?

    The drug addicts lying to me again about their last fix, seeing GP patients and driving to and back from football matches.

     

    The more unusual experiences to date?

    Dealing with an alleged murderer and attending forensic conferences learning about bomb squads and forensic pathology.

     

    Please describe your duties in a typical day.

    A&E involves seeing patients and supervising junior doctors and forensic medicine involves seeing detainees.

     

    What are the necessary personality characteristics for this career?

    Being an extrovert, having a strong personality and patience.

     

    What advice would you give to someone interested in pursuing this branch of medicine?

    Arm yourself with the appropriate courses.

     

    How competitive is this specialty?

    Becoming a crowd doctor can be quite competitive and forensic medicine can all depend on who you know.