Pre-Hospital Emergency Medicine focuses on the specialist provision of on-scene and in-transit critical care. It is a GMC approved sub-specialty of Anaesthesia, Intensive Care Medicine and Emergency Medicine and is available through national recruitment. For trainees in Anaesthetics, the programme consists of 12 months whole time equivalent training during ST6 or above, including post-CCT1.
PHEM is a varied, challenging and highly rewarding specialty. The Royal College of Anaesthetists have identified many ways in which formal training and subspecialisation in PHEM is beneficial for in-hospital teams, departments and the wider NHS1. These include:
- Optimising survivorship for seriously injured or critically ill patients.
- Improving and maintaining the quality and standards of pre-hospital critical care and inter-hospital transfer.
- Improving governance within pre-hospital care and inter-hospital transfer services.
- Enhancing the integration of pre-hospital systems and patient care pathways.
- Driving innovation in both hospital and community-based care.
- Enhancing departmental and consultant team expertise in emergency preparedness and response, including major incident management.
Training and Examinations in PHEM
PHEM training nationally is overseen by the Intercollegiate Board for Training in Pre-Hospital Emergency Medicine (IBTPHEM)2. Their website contains a variety of useful information, including a detailed outline of the PHEM training curriculum. More information is available via the following link:
Health Education England (West Midlands) proudly supports PHEM training for trainees in Anaesthetics, Intensive Care Medicine and Emergency Medicine3. For anaesthetists, the programme is typically blended over a two-year training period, resulting in one year of full time training in anaesthesia and one year of PHEM overall. The option of less than full-time training in PHEM is also available. The West Midlands PHEM training programme was one of the first in the UK and has been successfully completed by a number of trainees in Anaesthetics since. More information on the training programme in our region can be found here:
The Royal College of Anaesthetists has also produced a number of excellent resources for trainees considering a career in PHEM1. These include an overview of the PHEM training scheme, training timelines and detailed information on how the RCoA & PHEM curricula integrate. Further information is available via the following link:
Pre-Hospital Emergency Medicine (PHEM) Training | The Royal College of Anaesthetists (rcoa.ac.uk)
The PHEM training programme requires successful completion of two examinations, the Diploma in Immediate Medical Care and the Fellowship in Immediate Medical Care4. Further details can be found on Faculty of Pre-Hospital Care website : Examinations - The Faculty of Pre-Hospital Care (rcsed.ac.uk)
Recruitment to PHEM training is through a highly competitive national selection process at ST5 level for Anaesthetics trainees 2,5. Further details, including the most current personal specification, are available via the IBTPHEM and Health Education East of England websites:
Recruitment - The Intercollegiate Board for Training in Pre-Hospital Emergency Medicine | IBTPHEM
Pre - Hospital Emergency Medicine (PHEM) | East of England (hee.nhs.uk)
Trainees who are interested in pursuing a career in PHEM should obtain career advice early in their training, to ensure they are in a good position to apply for the national posts at the correct time. Trainees also need early approval from their anaesthetics TPD to undertake PHEM Training. The regional PHEM Training Programme Director or a local representative from the PHEM Trainees Association may be useful sources of further information.
1. Pre-Hospital Emergency Medicine (PHEM) Training | The Royal College of Anaesthetists (rcoa.ac.uk)
4. Examinations - The Faculty of Pre-Hospital Care (rcsed.ac.uk)
5. Pre - Hospital Emergency Medicine (PHEM) | East of England (hee.nhs.uk)