Patrick Plunkett said:
> FACEM and FAEM training are, on paper, very similar,
but there is a significant difference in that 5 years Higher Specialty
Training is mandatory under European rules, whereas FACEM only needs four
years. (30 months in Emergency Departments and 18 months in other
disciplines)
But most British trainees get 12 to 18 months of their
higher training lopped off at the outset, in recognition of SHO level
experience prior to their entry exam. This rather makes a mockery of Europe's
5 year higher training, doesn't it?
Patrick Plunkett said:
> The comment on clinical evaluation in the FFAEM is
noted, and known, but surely it is for a robust RITA system to ensure that
trainees are up to scratch clinically before presenting for the exam?
Only our profession can adequately decide whether a person is acceptable, but
they must do so in a reproducible, transparent and fairf ashion. That
makes clinical exams, performed in a ½ to 1 hour setting totally
unrealistic.
But the RITA system could not be considered robust for a
minute, it's a rubber stamping exercise! The RITA "assessment" is essentially
carried out by your trainer, although a panel then "assesses" the trainer's
assessment, if you see what I mean. There is a glaring conflict of interest -
no trainer wants to drag down his trainee, partly as trainers get close to
their trainees, and partly as trainees' shortcomings will inevitably
reflect on the trainer's unit and his training status. There's nothing wrong
with clinical exams if planned and executed well. We already rely on them for
most undergraduate and postgraduate exams; at least they are viewed
as relatively independent and that is more important than ever these days.
Conversely if you are going to use continuous assessment, then use
continuous assessment alone; an exam at the end should not be necessary and
will only devalue the continuous assessment!
Adrian Fogarty
