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Review
. 2016 Oct;16(5):427-431.
doi: 10.7861/clinmedicine.16-5-427.

Where did the acute medical trainees go? A review of the career pathways of acute care common stem acute medical trainees in London

Emily Gowland  1 , Karen Le Ball  2 , Catherine Bryant  2 , Jonathan Birns  2
Affiliations
Review

Where did the acute medical trainees go? A review of the career pathways of acute care common stem acute medical trainees in London

Emily Gowland et al. Clin Med (Lond). 2016 Oct.

Abstract

Acute care common stem acute medicine (ACCS AM) training was designed to develop competent multi-skilled acute physicians to manage patients with multimorbidity from 'door to discharge' in an era of increasing acute hospital admissions. Recent surveys by the Royal College of Physicians have suggested that acute medical specialties are proving less attractive to trainees. However, data on the career pathways taken by trainees completing core acute medical training has been lacking. Using London as a region with a 100% fill rate for its ACCS AM training programme, this study showed only 14% of trainees go on to higher specialty training in acute internal medicine and a further 10% to pursue higher medical specialty training with dual accreditation with internal medicine. 16% of trainees switched from ACCS AM to emergency medicine or anaesthetics during core ACCS training, and intensive care medicine proved to be the most popular career choice for ACCS AM trainees (21%). The ACCS AM training programme therefore does not appear to be providing what it was set out to do and this paper discusses the potential causes and effects.

Keywords: Acute care common stem; acute internal medicine; acute medicine; core medical training; training pathway.

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Figures

Fig 1.
Fig 1.
Training trajectories of ACCS AM trainees since inception of training programme. ACCS = acute care common stem; AM = acute medicine; CCT= certificate of completion of training.
Fig 2.
Fig 2.
Higher specialty career pathways of the trainees who have enrolled in ACCS AM in London since 2007. ACCS = acute care common stem; AIM = acute internal medicine; AM = acute medicine; GIM = general internal medicine; ICM = intensive care medicine.
Fig 3.
Fig 3.
Outcome of those embarking on ACCS AM training in London since 2007. ACCS = acute care ­common stem; AM = acute medicine.
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