ST1 to CCT
How ACCS Emergency Medicine training develops
The pathway is capability based, so a simple year-by-year list can mislead. The indicative route develops a broad acute-care base before increasingly independent Emergency Medicine practice, leadership and department management.
ACCS provides the common acute-care base
The first two years include Emergency Medicine, Internal or Acute Medicine, Anaesthetics and Intensive Care Medicine, commonly in six-month blocks. The aim is shared capability in the acutely ill patient, not four unrelated tasters.
ST3 is Emergency Medicine-specific intermediate training
Training turns toward the breadth of adult and paediatric Emergency Medicine, resuscitation, trauma, procedures and leadership. RCEM notes a six-month paediatric EM placement during CT/ST3. Exact rotation order varies locally.
ST4–ST6 build senior decision-making
Higher training develops management of the whole ED, complex resuscitation, supervision, teaching, governance, QI and leadership alongside clinical breadth. Progress is judged against Specialty Learning Outcomes and the programme of assessment, not time served alone.
2027 entry is run-through; core references are historical
The 2026/2027 applying page removes Core Training entry. Older descriptions of core CT1 concern previous recruitment routes, and existing core trainees should check their progression requirements. Run-through ST1 leads toward ST6 subject to satisfactory ARCP and examination progression.
The 2025 curriculum update is current
GMC-approved updates took effect on 6 August 2025. RCEM states that the underlying clinical syllabus and overall training structure remained in place, while capabilities and assessment wording were updated. Use the current document rather than an older summary.
LTFT and time out of programme are possible
Capability-based progression can accommodate less-than-full-time training and approved out-of-programme experience. Duration and rotation planning change, and exam, placement and CCT dates need individual discussion with the training programme.
Full-time EM training is defined as 40 hours a week
RCEM clarified in May 2025 that full-time Emergency Medicine training is 40 hours per week. Rota composition, night frequency and time in each clinical area still vary, so hours alone do not describe the lived workload.
From understanding to practice
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