Pre-Hospital Emergency Medicine (PHEM) Training
The term pre-hospital care covers a wide range of medical conditions, interventions, clinical providers and physical locations. Pre-hospital care can range from minor illness or injury to life-threatening emergencies, requiring a range of interventions from simple first aid to advanced emergency care and pre-hospital emergency anaesthesia.
Pre-Hospital Emergency Medicine (PHEM) subspecialist practice relates to the Emergency Response, Primary Scene Transfer, and Secondary Emergency Transfer functions at the level of the consultant (level 8) practitioner. PHEM primarily relates to that area of medical care required for seriously ill or injured patients before they reach hospital (on-scene) or during emergency transfer to hospital (in-transit). It represents a unique area of medical practice which requires the focused application of a defined range of knowledge and skills to a level not normally available outside hospital.
PHEM is a sub-specialty of Anaesthesia and is available through national recruitment, consisting of 12 months whole time equivalent training during ST6 or above, including post-CCT. There are a small number of one-year PHEM posts nationally, but the majority are combined or blended training programmes (one year of anaesthesia and one year of PHEM) over a two-year training period. Less than full-time training in PHEM training is also available.
It is recommended that career advice is sought early for trainees who are interested in sub-specialty PHEM training. Anaesthetists in training can get more information from the Intercollegiate Board for Training in Pre-Hospital Emergency Medicine (IBTPHEM) website [external link], the regional PHEM Training Programme Director [external link], or a local representative from the PHEM Trainees Association [external link]. Crucial reading for anyone considering training in PHEM is the Sub-Speciality Training in PHEM: Curriculum, Syllabus and Assessment System [external link].
Curriculum and Prehospital Emergency Medicine: A Guide for Trainees and Trainers
The Prehospital Emergency Medicine: A Guide for Trainees and Trainers was published in October 2022 [pdf].
This guide provides details on the following areas:
- PHEM Training Scheme Overview
- Training Timelines
- Eligibility and Considerations for Stage 1 Anaesthetic Training
- RCoA & PHEM Curriculum Integration.
A guide intended for use by anaesthetists in training who are doing sub-specialty training in PHEM can be found here. It demonstrates the shared capabilities and cross-referencing between the two curricula. This guide is also included in the stage 3 SIAs HALO guide.
Pre-Hospital Emergency Medicine Recruitment
National recruitment for posts open in September, for both the August and February intakes. Full details can be found on the IBTPHEM website [external link], or directly from the Health Education England East of England website [external link] as the hosting organisation for PHEM national recruitment.
College Support for PHEM Training
Maintaining PHEM skills
The College supports anaesthetists in training who have completed PHEM sub-specialty training to be released for 1 to 2 ‘keeping in touch’ days per month to enable them to maintain currency with their PHEM practice.
This is at the discretion of the local School of Anaesthesia and should not distract from completing anaesthetic training. Military trainees should contact their Defence Consultant Advisor as days maintaining contact can also be permitted.
Supervision of PHEM training
The College also recommends that anaesthetists in PHEM training should have an Educational Supervisor who has familiarity and access to the Lifelong Learning platform during their PHEM training programme. If this cannot be facilitated by the providing PHEM training scheme, the PHEM educational supervisor should liaise with the anaesthetist in training's anaesthetic supervisor early, to ensure effective cross-linking of shared capabilities.
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Last reviewed: 23 November 2022
Next review due: 22 November 2023