Robert Cocks wrote:
>Surgical and Medical routes, Simon? I thought that we had got rid of that concept years ago (certainly General FRCS didn't offer the most appropriate >training for A&E, nor MRCP alone - ouch... I can feel the knives going in already). The whole concept of the FRCS (A&E) (now becoming MRCS A&E) was >intended to combine equal amounts of Medicine, Surgery and A&E with the exam set by both the RCS and RCP (even though the final ticket came as the >FRCS in Accident and Emergency Medicine and Surgery). The commitment of the Colleges to the concept is shown by the acceptance of non-surgical >primaries, e.g. 1st part MRCP.
You still need either the surgical or medical primary. Since the MRCS requires 4 surgical posts this is what is locally known as the "surgical route". The MRCP requires someone to pass an exam in a subject increasingly distant from acute, emergency medicine. Few people pass it after a 6 month post in general medicine, they end up doing a year or more in medicine - the medical route! Then, in order to get qualified for the FRCS (A+E) they need additional experience in other things. I have a few friends who took a long time to get MRCP part 1 (because it is largely irrelevant to what we do) then creamed the FRCS (A+E) first time.
It may be that you thought I had not done the A+E exam (I did after FRCS primary), rather the FRCS in general. That may be my mistake for making that unclear. I think you can still get an SpR post without FRCS (A+E) i.e. with MRCP or FRCS in general - but it is becoming much less common locally.
The problems of the part one hurdle has been debated on the list in the past. The simple answer is to get an A+E primary - but that is far easier said than done!!!!
Simon
Simon Carley
SpR in Emergency Medicine
Hope Hospital
Salford
England
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-----Original Message-----
From: Robert Anthony COCKS <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 15 December 1999 02:04
Subject: RE: Acute Medicine
In Hong Kong, the College of Emergency Medicine runs an intermediate exam (IEEM) conjointly with the FRCS (A&E) Ed., with examiners from both Colleges. The granting of FRCS (A&E) will carry on until 2003 for non-EU graduates who started their A&E training before August 1996, whereas in Edinburgh examinations for the Fellowship will cease in 2000. We will start offering the MRCS (A&E) Ed in parallel from March 2000 in Hong Kong for those trainees who started after Aug 1996.
Rob Cocks Hong Kong
-----Original Message-----
From: Simon Carley [mailto:[log in to unmask]]
Sent: Tuesday, December 14, 1999 6:22 PM
To: acadae messages
Subject: Re: Acute Medicine
I have just completed my 3 month secondment in medicine at a large teaching
hospital and found myself doing far, far less "acute medicine" as a member
of the medical team than I do as an A+E SpR. However, this may vary between
hospitals, as my current one is fairly proactive. I am certainly aware of
other places where for whatecver reason(staffing, enthusiasm,tradition, lack
of senior support) there was no encouragment to manage acute medical cases.
I perceive that we are doing much more now than 3-5 years ago, and this may
be reflected in the increasing number of SpR's (locally) who come from an
MRCP rather than FRCS background (which is no bad thing!!).
Simon - who took the surgical route
Simon Carley
SpR in Emergency Medicine
Hope Hospital
Salford
England
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-----Original Message-----
From: Meek, Steve <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 13 December 1999 20:43
Subject: RE: Acute Medicine
>
>
>> ----------
>>
> "As the legal requirement for Consultant appointment is merely to be
>o the
>> Specialist register I suspect that a CCST in A&E spending as much time as
>> possible on medically related things would e the best option".
>>
>> Agreed. To get training in acute medicine you need trainers.
>> There is only one specialty where the consultants have up to date
personal
>> experience of treating a range of acutely ill medical patients - ours.
>> When did a consultant cardiologist last treat acute severe LVF? Or the
>> consultant diabetologist put a central line in a DKA?
>>
>> Yes, I know there are a few intensivist types who do see acute
>> presentations, but generally we all know it is rare. I heard recently of
a
>> cons cardiologist in the SouthWest who tried to stop A&E using CPAP in
LVF
>> as it was 'dangerous'.and 'untried'...
>> Don't get me wrong, general physicians all work hard - but not at medical
>> emergencies. Even endocarditis or neutropenia... initial management is
>> still relatively straighforward, with telephone advice from the
>> microbiologist or haematologist as appropriate.
>> Steve Meek
>>
>
