The examination formerly known as FRCSEd(A&E) is a diploma of a surgical
royal college but its full name was Fellowship of the Royal College of
Surgeons in Accident and Emergency Medicine and Surgery. This duality is
still reflected in the format of the exam. The medicine gained in the
required experience is tested in the exam, to the best of my knowledge.
The exam is thus seeking to test just the type of expertise needed in A&E
work. It is appropriately one of the "tickets" to show a trainee is
eligible for entry to SpR training.
Cheers
Jonathan Marrow
----- Original Message -----
From: "Cliff Reid" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 17, 2001 01:17
Subject: Re: Composite house jobs and future ED docs
> Good points. I know a very senior member of the specialty who told someone
> with MRCSEd(A&E) who was enquiring about an SpR post that he/she didn't
rate
> the exam as much as FRCS or MRCP. The reason given was that to get the A&E
> exam, it's never necessary to work as more than a junior SHO in any
> specialty, whereas the acquisition of one of the other exams implies that
> registrar level has been reached in a specialty and therefore the doctor
has
> experienced working at more senior level of competence and responsibility.
> While this negative response only served to discourage the poor girl, the
> points raised give food for thought.
>
> I do however feel we should support our own specialty's exam. While I'm
sure
> some of the knowledge and many of the practical skills acquired for FRCS
are
> useful in A&E, I don't see a lot of the Charcot-Marie-Tooth disease or
> dystrophia myotonica that was so important for MRCP. I DO see a lot of
acute
> medicine though, so it seems to me the experience from the jobs is
markedly
> more useful than the exam you get at the end of them. Maybe when we get
SpR
> secondments right that will go some way towards avoiding the 'narrowly
> focussed set of skills' you and I are wary of.
>
> I'd be interested to hear of anyone's experience of US emergency
physicians.
> I understand they only have 4 year residencies in EM, which they can enter
> straight after med school, and we don't hear of their skills being
narrowly
> focussed. I'm sure it boils down to differences in interpretation of the
> word 'training'. In the UK an SpR is so often left to his own devices for
> most of his training he HAS to rely on the skills and knowledge acquired
> during his SHO posts. As the Faculty works to improve the structure and
> content of SpR training, we should all finish up with excellent
broad-based
> abilities regardless of what post-nominal letters we traded a happy life
in
> our 20's to acquire. Until we get there, I agree with you that the
> broader-based our experience, the more we can offer our patients.
>
> Cliff
> Paed registrar without MRCPCH, and suffering!
> Australia
>
>
> >From: Stephen Hughes <[log in to unmask]>
>
>
> >We should all be moving towards senior-based care.
>
> >That requires entrants to the specialty with a lot of experience.
> >
> >Such experience should be broad-based.
> >
> >That takes time.
> >
> >In short, there are no short-cuts if you want to practice A/E medicine,
> >which as we all know stands for "Anything and Everything".
> >
> >While we're at it, is the FRCS(A/E) such a good idea anyway? One of the
> >things that I like about A/E is the broad background of many of us. On
> >my own rotation, there are physicians, surgeons and a radiologist as
> >well as holders of the A/E exam. (The anaesthetist wandered off back to
> >anaesthetics a couple of years ago).
> >
> >Of the last group, they are far from the homogenous "one size fits all"
> >group nightmare, but I think that in the future, an abbreviated training
> >with a narrowly focussed set of skills will not do the specialty any
> >favours.
> >--
> >Stephen Hughes FRCSEd (Not A/E)
>
>
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