Plan backwards from Oriel
A realistic ACCS Emergency Medicine application timeline
There is no current ST1 points grid to chase. Use the long runway to test whether the work fits you, finish a few credible activities and build MSRA and interview fluency without neglecting the application itself.
12+ months: understand the department beyond resus
Seek exposure to majors, minors, paediatrics, mental health, frailty, ambulatory pathways and handover as well as resuscitation. Begin one bounded QI, teaching or research-network contribution that can realistically finish. If you have no ED post, relevant acute medicine, surgery, paediatrics, general practice and critical-care experience still provide useful examples.
6–12 months: finish work and collect factual records
Complete the measurement, teaching feedback, poster, handover tool or governance presentation you can own. Keep dates, your exact role, outcomes and supervisor details. Start regular MSRA practice early enough to review reasoning rather than only counting questions.
3–6 months: map examples to the person specification
Build an example index for prioritisation, uncertainty, patient safety, communication, teamwork, leadership, QI, teaching, research and commitment. Read the ACCS and EM curricula so your motivation answer describes the actual pathway rather than a preference for excitement.
Final weeks before submission: remove preventable errors
Check registration, Foundation competence evidence, employment gaps, referee details and any reapplication form. For 2027, EM accepts only the 2024 or 2027 CREST versions where CREST is required; an older signed form must still meet current validity rules. Submit the correct form by the deadline and leave time for Oriel validation.
After submission: protect MSRA preparation time
The 2027 process requires a fresh MSRA sitting and uses total score for capacity-based shortlisting. Practise both Clinical Problem Solving and Professional Dilemmas, review errors by reasoning category and make test-day arrangements early.
Interview period: move from notes to spoken decisions
Reduce each portfolio example to a clear claim, personal action, outcome and learning. Practise clinical and ethical prompts in 10-minute blocks, including interruption and follow-up. Test camera, sound, identification and room setup for the confirmed online interview.
Before offers: compare programmes and rank honestly
For 2027, apply for run-through ST1: there is no Core Training entry option. Compare geography, the four ACCS placements, paediatric exposure, on-call supervision, tertiary and DGH mix, research access, LTFT and commute. Rank every post you would accept rather than trying to predict the cut-off.
From understanding to practice
Put this topic into an interview answer
Use EM portfolio station for original prompts and an answer structure relevant to this topic.
Explore ACCS Emergency Medicine practiceExplore the Question bank and spoken practice coming at launch.Spoken practice is launching soon. Use the free questions and guides to start preparing now.
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